Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan.
Division of Legal Medicine, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Int J Legal Med. 2017 Nov;131(6):1739-1746. doi: 10.1007/s00414-017-1657-8. Epub 2017 Aug 15.
The crush syndrome, in which rhabdomyolysis and trauma occur as a result of heat stroke and drug intoxication, can lead to myoglobinemia. This condition can be diagnosed by measuring myoglobin (Mb) levels in blood and urine. However, postmortem Mb levels are unreliable indicators, since blood Mb concentration drastically increases within a very short time after death and urine cannot always be obtained at dissection; this makes it difficult to diagnose myoglobinemia in a corpse. To address this issue, in this study, we used a lipidomics approach to identify markers that can be used to detect myoglobinemia in postmortem blood samples. We found that increases in levels of fatty acid oxides such as stearic, oleic, linoleic, and arachidonic acid and decreases in levels of plasmalogens and phosphatidylethanolamine in the blood were associated with high Mb level. These results demonstrate that postmortem samples are amenable to lipidomics analysis and provide a set of markers other than Mb that can be used for postmortem diagnosis of myoglobinemia.
挤压综合征，其中横纹肌溶解症和创伤发生由于中暑和药物中毒，可导致肌红蛋白尿。这种情况可以通过测量血液和尿液中的肌红蛋白（Mb）水平来诊断。然而，死后 Mb 水平是不可靠的指标，因为血液 Mb 浓度在死亡后很短的时间内急剧增加，而且在解剖时并不总能获得尿液；这使得在尸体中诊断肌红蛋白尿变得困难。为了解决这个问题，在这项研究中，我们使用了一种脂质组学方法来鉴定可以用于检测死后血液样本中肌红蛋白尿的标志物。我们发现，血液中脂肪酸氧化物（如硬脂酸、油酸、亚油酸和花生四烯酸）水平的升高和血浆类脂和磷脂酰乙醇胺水平的降低与 Mb 水平升高有关。这些结果表明，死后样本适合进行脂质组学分析，并提供了一组除 Mb 以外的标志物，可用于死后肌红蛋白尿的诊断。
