Viinamäki Jenni, Sajantila Antti, Ojanperä Ilkka
Department of Forensic Medicine, University of Helsinki, PO Box 40, FI-00014 Helsinki, Finland
Department of Forensic Medicine, University of Helsinki, PO Box 40, FI-00014 Helsinki, Finland.
J Anal Toxicol. 2015 Jul-Aug;39(6):481-5. doi: 10.1093/jat/bkv044. Epub 2015 Apr 23.
Ethylene glycol (EG) is used in antifreeze and other industrial products. It metabolizes to glycolic acid (GA) and oxalic acid (OX) that cause metabolic acidosis and are mainly responsible for the toxicity of EG. During 2010-2014, EG or GA was found in 25 postmortem cases in Finland. Of these cases, 21 were classified as fatal EG poisonings and 3 were classified as methanol (MeOH) poisonings. In this study, we report the concentrations of EG and GA in postmortem blood and urine samples of fatal EG or mixed MeOH/EG poisonings. In the fatal EG poisonings, the median EG and GA concentrations were 0.87 and 1.6 g/L in blood and 4.3 and 5.3 g/L in urine. The median urine-blood ratios were 3.8 and 3.1 for EG and GA. These results warrant the use of urine as a primary matrix for screening. In EG positive cases, the quantification of both EG and GA in blood is crucial as GA concentration appears to best indicate a fatal poisoning with an approximate threshold of 1.5 g/L. The measurement of urinary OX does not offer much additional value to toxic alcohol screening as it may originate from varying dietary conditions.
乙二醇（EG）用于防冻液和其他工业产品中。它代谢生成乙醇酸（GA）和草酸（OX），可导致代谢性酸中毒，且是乙二醇毒性的主要成因。在2010年至2014年期间，芬兰的25例尸检案例中发现了乙二醇或乙醇酸。在这些案例中，21例被归类为致命的乙二醇中毒，3例被归类为甲醇（MeOH）中毒。在本研究中，我们报告了致命的乙二醇中毒或甲醇/乙二醇混合中毒案例的尸检血液和尿液样本中乙二醇和乙醇酸的浓度。在致命的乙二醇中毒案例中，血液中乙二醇和乙醇酸的中位数浓度分别为0.87 g/L和1.6 g/L，尿液中分别为4.3 g/L和5.3 g/L。乙二醇和乙醇酸的尿血比中位数分别为3.8和3.1。这些结果证明尿液可作为筛查的主要基质。在乙二醇呈阳性的案例中，血液中乙二醇和乙醇酸的定量分析至关重要，因为乙醇酸浓度似乎最能表明致命中毒情况，其近似阈值为1.5 g/L。尿液中草酸的检测对有毒醇类筛查没有太大的额外价值，因为它可能源自不同的饮食状况。
