Mori A, Mukaida M, Ishiyama I, Hori J, Okada Y, Sasaki M, Mii K, Mizugaki M
Department of Forensic Medicine, Faculty of Medicine, University of Tokyo, Japan.
Nihon Hoigaku Zasshi. 1990 Aug;44(4):352-7.
A case of homicidal poisoning by aconite is reported from the viewpoint of clinical forensic medicine and analytical chemistry. Jesaconitine was detected in the vomitus, stomach contents, plasma and urine at concentrations of 32.2, 5.48, 0.433 and 1.07 micrograms/ml, respectively. The total amount of jesaconitine in the stomach contents was 1.3 mg. Macroscopic autopsy revealed hemorrhagic pulmonary edema, and histologically, diffuse contraction-band necrosis was evident in the myocardium. Exogenous administration of adrenaline or endogenous release of catecholamines are known to induce hemorrhagic pulmonary edema and contraction-band necrosis, and aconitine is reported to cause release of endogenous catecholamines centrally and to induce neurogenic pulmonary edema and ventricular-type arrhythmia. Therefore, the chief cause of death in this case was considered to be aconite-induced centrogenic arrhythmia.
从临床法医学和分析化学的角度报告了一例乌头碱杀人中毒案件。在呕吐物、胃内容物、血浆和尿液中检测到滇乌碱，浓度分别为32.2、5.48、0.433和1.07微克/毫升。胃内容物中滇乌碱的总量为1.3毫克。大体尸检显示出血性肺水肿，组织学检查显示心肌有明显的弥漫性收缩带坏死。已知外源性给予肾上腺素或内源性释放儿茶酚胺可引起出血性肺水肿和收缩带坏死，据报道乌头碱可引起中枢内源性儿茶酚胺释放，并诱发神经源性肺水肿和室性心律失常。因此，本案的主要死因被认为是乌头碱引起的中枢性心律失常。
