Domingo Olwen, Roider Gabriele, Stöver Andreas, Graw Matthias, Musshoff Frank, Sachs Hans, Bicker Wolfgang
Institute of Forensic Medicine, Department of Toxicology, University of Munich, 80336 Munich, Germany.
Institute of Forensic Medicine, Department of Toxicology, University of Munich, 80336 Munich, Germany.
Forensic Sci Int. 2017 Feb;271:e1-e7. doi: 10.1016/j.forsciint.2016.12.020. Epub 2016 Dec 23.
Two cases of fatalities are reported of which the recreational use of Mitragyna speciosa ("kratom") could be confirmed. One of these cases presents with one of the highest postmortem mitragynine concentrations published to date. Our results show that even extremely high mitragynine blood concentrations following the consumption of kratom do not necessarily have to be the direct cause of death in such fatalities as a result of an acute overdose. The two cases are compared with regard to the differences in mitragynine concentrations detected and the role of mitragynine in the death of the subjects. Irrespective of the big differences in mitragynine concentrations in the postmortem blood samples, mitragynine was not the primary cause of death in either of the two cases reported here. Additionally, by rough estimation, a significant difference in ratio of mitragynine to its diastereomers in the blood and urine samples between the two cases could be seen.
报告了两例死亡病例，其中可以确认死者有娱乐性使用帽柱木属植物（“ kratom”）的情况。其中一例的尸检中发现的帽柱木碱浓度是迄今为止公布的最高浓度之一。我们的结果表明，即使在食用kratom后血液中的帽柱木碱浓度极高，也不一定是此类急性过量致死的直接死因。比较了这两例病例中检测到的帽柱木碱浓度差异以及帽柱木碱在受试者死亡中的作用。尽管尸检血样中帽柱木碱浓度存在很大差异，但本文报告的两例病例中，帽柱木碱均不是主要死因。此外，通过粗略估计，可以看出两例病例的血液和尿液样本中帽柱木碱与其非对映异构体的比例存在显著差异。
