Andrews Rebecca, Murphy Kevin G, Nahar Limon, Paterson Sue
Toxicology Unit, Imperial College London, London, UK, W6 8RP;
Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK.
Clin Chem. 2015 Oct;61(10):1256-64. doi: 10.1373/clinchem.2015.240846. Epub 2015 Aug 3.
Acute cannabis consumption nearly doubles the risk of motor vehicle collision resulting in injury or death. Limited data have been published regarding the concentrations of cannabinoids associated with fatal road traffic collisions (RTCs), and these have not previously been compared to a population of other postmortem cases.
We conducted analysis for cannabinoids [Δ(9)-tetrahydrocannabinol (THC), 11-hydroxy-THC, 11-nor-THC-9-carboxylic acid, cannabidiol, and cannabinol], drugs, and alcohol on consecutive fatal RTC cases (100) and non-RTC cases (114) from coroners' jurisdictions in London and southeast England and compared the data.
The incidence of cannabinoids detected in non-RTC and RTC cases was similar (25% vs 21%, P = 0.44), but THC was detected more frequently (90% vs 59%, P = 0.01) and at significantly higher concentrations in the cannabinoid-positive RTC cases than the non-RTC cases (P = 0.01). The distribution of non-RTC and RTC cases over 4 categories of THC concentration was significantly different (P = 0.004). There was no significant difference in the concentrations of other cannabinoids detected between the 2 groups. Cannabinoids were detected in more fatal RTC cases (21) than alcohol >80 mg/dL (17). Detection of other drugs was low compared to cannabis and alcohol.
These first data on the concentrations of cannabinoids in the postmortem blood of fatal RTC victims compared with a population of other routine coroners' cases highlight the importance of specifically measuring THC concentrations in the blood to aid interpretation of postmortem cases where cannabis may be implicated.
急性吸食大麻会使机动车碰撞导致受伤或死亡的风险几乎增加一倍。关于与致命道路交通碰撞（RTC）相关的大麻素浓度的已发表数据有限，且此前未与其他尸检病例群体进行比较。
我们对来自伦敦和英格兰东南部验尸官辖区的连续100例致命RTC病例和114例非RTC病例的大麻素[Δ⁹ - 四氢大麻酚（THC）、11 - 羟基 - THC、11 - 去甲 - THC - 9 - 羧酸、大麻二酚和大麻酚]、药物和酒精进行了分析，并比较了数据。
在非RTC病例和RTC病例中检测到大麻素的发生率相似（25%对21%，P = 0.44），但在大麻素阳性的RTC病例中，THC的检测频率更高（90%对59%，P = 0.01），且浓度显著高于非RTC病例（P = 0.01）。非RTC病例和RTC病例在4类THC浓度上的分布存在显著差异（P = 0.004）。两组之间检测到的其他大麻素浓度没有显著差异。在更多的致命RTC病例（21例）中检测到大麻素，而酒精浓度>80 mg/dL的病例有17例。与大麻和酒精相比，其他药物的检测率较低。
这些关于致命RTC受害者尸检血液中大麻素浓度的首批数据与其他常规验尸官病例群体进行比较，突出了专门测量血液中THC浓度对于协助解释可能涉及大麻的尸检病例的重要性。
