University Center of Legal Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland.
Forensic Sci Int. 2013 Mar 10;226(1-3):54-61. doi: 10.1016/j.forsciint.2012.12.007. Epub 2013 Jan 10.
The aim of this study was to investigate the usefulness of postmortem biochemical investigations in the diagnosis of fatal hypothermia. 10 cases of fatal hypothermia and 30 control cases were selected. A series of biochemical parameters, such as glucose, acetone, 3-beta-hydroxybutyrate, isopropyl alcohol, free fatty acids, adrenaline, growth hormone, adrenocorticotropic hormone, thyroid-stimulating hormone, cortisol, calcium, magnesium, C-reactive protein, procalcitonin as well as markers of renal and cardiac functions were measured in blood, postmortem serum from femoral blood, urine, vitreous and pericardial fluid. The results suggested that deaths due to hypothermia, especially in free-ethanol cases, are characterized by increased ketone levels in blood and other biological fluids, increased adrenaline concentrations in urine, increased cortisol levels in postmortem serum from femoral blood and increased free cortisol values in urine. Increased or decreased levels of other biological parameters are either the result of terminal metabolic changes or the expression of preexisting diseases and may provide information to elucidate the death process on a case-by-case basis.
本研究旨在探讨死后生化检查在致命性低体温诊断中的作用。选择了 10 例致命性低体温和 30 例对照病例。测量了一系列生化参数，如血糖、丙酮、3-β-羟丁酸、异丙醇、游离脂肪酸、肾上腺素、生长激素、促肾上腺皮质激素、促甲状腺激素、皮质醇、钙、镁、C 反应蛋白、降钙素以及肾功能和心功能标志物，在血液、股动脉血死后血清、尿液、玻璃体液和心包液中。结果表明，低体温导致的死亡，尤其是在游离乙醇的情况下，其特征是血液和其他生物液体中酮体水平升高，尿液中肾上腺素浓度升高，股动脉血死后血清中皮质醇水平升高，尿液中游离皮质醇值升高。其他生物参数水平的升高或降低要么是终末代谢变化的结果，要么是先前疾病的表现，并可能提供信息，逐个案例阐明死亡过程。
