Milroy C M
Eastern Ontario Forensic Pathology, Unit of the Ontario Forensic Pathology Service, Division of Anatomical Pathology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K2A 2L4, Canada.
Forensic Sci Med Pathol. 2011 Sep;7(3):248-52. doi: 10.1007/s12024-010-9220-7. Epub 2011 Jan 25.
Amphetamine derivative drugs, particularly 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, are popular recreational drugs. MDMA is associated with causing death by a number of mechanisms, including hyperpyrexia, cardiac arrhythmia water intoxication and liver failure. Seventy-seven deaths where MDMA was detected in body fluids/organs were reviewed. Of these cases 59 deaths had MDMA present in blood. In 13 cases death was attributable to the toxic effects of MDMA alone with a range of 0.478-53.9 mg/l, mean 8.43 mg/l, median 3.49 mg/l. In 22 cases death was due to polydrug use, with an MDMA range of 0.04-41.5 mg/l, mean 2.90 mg/l, median 0.76 mg/l. In 24 cases death was due to trauma with an MDMA range of 0.035-4.81 mg/l, mean 0.862 mg/l, median 0. 483 mg/l. There is considerable overlap between the concentration of MDMA seen in deaths from direct MDMA toxicity and deaths associated with trauma. These findings show, that like other stimulant drugs, no specific concentration can be used to determine death without consideration of the history and full autopsy findings.
苯丙胺类衍生物药物，尤其是3,4-亚甲基二氧基甲基苯丙胺（MDMA），俗称摇头丸，是常见的消遣性毒品。MDMA可通过多种机制导致死亡，包括高热、心律失常、水中毒和肝衰竭。对77例在体液/器官中检测到MDMA的死亡病例进行了回顾。在这些病例中，59例血液中检测到MDMA。13例死亡仅归因于MDMA的毒性作用，其浓度范围为0.478 - 53.9毫克/升，平均8.43毫克/升，中位数3.49毫克/升。22例死亡是由于多药使用，MDMA浓度范围为0.04 - 41.5毫克/升，平均2.90毫克/升，中位数0.76毫克/升。24例死亡是由于外伤，MDMA浓度范围为0.035 - 4.81毫克/升，平均0.862毫克/升，中位数0.483毫克/升。直接MDMA毒性导致的死亡和与外伤相关的死亡中所见的MDMA浓度之间存在相当大的重叠。这些发现表明，与其他兴奋剂药物一样，在不考虑病史和完整尸检结果的情况下，无法使用特定浓度来确定死亡原因。
