APHM, Hôpital de la Timone, Service de Médecine Légale, Marseille, France.
Aix-Marseille Univ, APHM, Hôpital de la Timone, Service de Médecine Légale, Marseille, France.
Curr Pharm Des. 2017;23(36):5530-5541. doi: 10.2174/1381612823666170622111739.
Drug concentrations obtained from post mortem samples do not necessarily reflect the concentrations at the time of death, and variations of concentration may be observed between different sites and/or different sampling times. These phenomena, collectively termed post mortem redistribution, concern numerous molecules (medications, drugs of abuse, gases, etc.) and can complicate the interpretation of toxicological analyses.
Literature review.
The mechanisms that cause these phenomena are complex and often intricate. Certain organs, which concentrate the molecules before death, may release them very early in the vascular sector. The gastrointestinal tract, liver, lungs and myocardium are mainly concerned. Cell autolysis also plays a part in drug release. Furthermore, micro-organisms (mainly bacteria and yeasts) which colonize the organism during putrefaction may cause neoformation and/or the degradation of certain molecules. Lastly, it appears that the physicochemical and pharmacokinetic profile of xenobiotics, notably their lipophilic nature, their ionization state and their volume of distribution may be factors likely to influence redistribution phenomena. Some recommendations concerning anatomic sampling sites, sampling methods and sample storage make it possible to limit these phenomena.
尸检样本中获得的药物浓度不一定反映死亡时的浓度，并且在不同部位和/或不同采样时间可能会观察到浓度变化。这些现象统称为死后再分布，涉及许多分子（药物、滥用药物、气体等），可能会使毒理学分析的解释复杂化。
文献回顾。
导致这些现象的机制很复杂，通常也很复杂。某些在死亡前浓缩分子的器官可能会在血管区域非常早期释放它们。胃肠道、肝脏、肺部和心肌主要受到影响。细胞自溶也参与药物释放。此外，在腐败过程中定植于生物体的微生物（主要是细菌和酵母）可能会导致某些分子的新形成和/或降解。最后，似乎外源性物质的物理化学和药代动力学特征，尤其是它们的亲脂性、离解状态和分布容积，可能是影响再分布现象的因素。关于解剖采样部位、采样方法和样品储存的一些建议可限制这些现象。
