Poklis Justin, Poklis Alphonse, Wolf Carl, Hathaway Cindie, Arbefeville Elise, Chrostowski Leszek, Devers Kelly, Hair Laura, Mainland Mary, Merves Michele, Pearson Julia
Department of Pharmacology and Toxicology, Virginia Commonwealth University, PO Box 980613, Richmond, VA 23298-0613, USA.
Department of Pharmacology and Toxicology, Virginia Commonwealth University, PO Box 980613, Richmond, VA 23298-0613, USA Department of Pathology, Virginia Commonwealth University, PO Box 980165, Richmond, VA 23298-0165, USA Department of Forensic Science, Virginia Commonwealth University, PO Box 843079, Richmond, VA 23284-3079, USA.
J Anal Toxicol. 2016 Oct;40(8):703-708. doi: 10.1093/jat/bkw048. Epub 2016 Jun 23.
We present the case histories, autopsy findings and toxicology findings of two fatal intoxications involving the designer drug, butyryl fentanyl. The quantitative analysis of butyryl fentanyl in postmortem fluids and tissues was performed by an ultrahigh-performance liquid chromatography tandem mass spectrometry method. In the first case, butyryl fentanyl was the only drug detected with concentrations of 99 ng/mL in peripheral blood, 220 ng/mL in heart blood, 32 ng/mL in vitreous humor, 590 ng/mL in gastric contents, 93 ng/g in brain, 41 ng/g in liver, 260 ng/mL in bile and 64 ng/mL in urine. The cause of death was ruled fatal intoxication by butyryl fentanyl. In the second case, butyryl fentanyl was detected along with acetyl fentanyl, alprazolam and ethanol. The butyryl fentanyl concentrations were 3.7 ng/mL in peripheral blood, 9.2 ng/mL in heart blood, 9.8 ng/mL in vitreous humor, 4,000 ng/mL in gastric contents, 63 ng/g in brain, 39 ng/g in liver, 49 ng/mL in bile and 2 ng/mL in urine. The acetyl fentanyl concentrations were 21 ng/mL in peripheral blood, 95 ng/mL in heart blood, 68 ng/mL in vitreous humor, 28,000 ng/mL in gastric contents, 200 ng/g in brain, 160 ng/g in liver, 330 ng/mL in bile and 8 ng/mL in urine. In addition, the alprazolam concentration was 40 ng/mL and the ethanol concentration was 0.11 g/dL, both measured in peripheral blood. The cause of death in the second case was ruled a mixed drug intoxication. In both cases, the manner of death was accident.
我们介绍了两起涉及新型毒品丁酰芬太尼的致命中毒案例的病史、尸检结果和毒理学结果。采用超高效液相色谱串联质谱法对死后体液和组织中的丁酰芬太尼进行定量分析。在第一起案例中，丁酰芬太尼是唯一检测到的药物，外周血中浓度为99纳克/毫升，心脏血中为220纳克/毫升，玻璃体液中为32纳克/毫升，胃内容物中为590纳克/毫升，脑中为93纳克/克，肝脏中为41纳克/克，胆汁中为260纳克/毫升，尿液中为64纳克/毫升。死亡原因判定为丁酰芬太尼致命中毒。在第二起案例中，检测到丁酰芬太尼的同时还发现了乙酰芬太尼、阿普唑仑和乙醇。丁酰芬太尼的浓度在外周血中为3.7纳克/毫升，心脏血中为9.2纳克/毫升，玻璃体液中为9.8纳克/毫升，胃内容物中为4000纳克/毫升，脑中为63纳克/克，肝脏中为39纳克/克，胆汁中为49纳克/毫升，尿液中为2纳克/毫升。乙酰芬太尼的浓度在外周血中为21纳克/毫升，心脏血中为95纳克/毫升，玻璃体液中为68纳克/毫升，胃内容物中为28000纳克/毫升，脑中为200纳克/克，肝脏中为160纳克/克，胆汁中为330纳克/毫升，尿液中为8纳克/毫升。此外，外周血中测得阿普唑仑浓度为40纳克/毫升，乙醇浓度为0.11克/分升。第二起案例的死亡原因判定为混合药物中毒。两起案例的死亡方式均为意外。
