Darke Shane, Duflou Johan, Lappin Julia, Kaye Sharlene
National Drug& Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
J Forensic Sci. 2018 Sep;63(5):1466-1471. doi: 10.1111/1556-4029.13710. Epub 2017 Nov 29.
Characteristics of death attributed solely to methamphetamine toxicity (MT, n = 93) by forensic pathologists were examined and compared to cases of multiple drug toxicity (MDT, n = 634). The mean age of MT cases was 36.7 years, and 86.0% were male. Strenuous activity was reported in 12.9%. The most common witness observations were: collapse (60.3%), difficulty in breathing (36.2%), and hyperthermia (27.6%). MT cases had higher blood methamphetamine (0.54 vs. 0.11 mg/L) and amphetamine (0.04 vs. 0.02 mg/L) concentrations and lower likelihoods for opioids (12.5% vs. 80.9%), hypnosedatives (27.3 vs. 60.7%), antidepressants (14.8 vs. 29.8%), and antipsychotics (9.1 vs. 19.7%). MT cases had significantly heavier hearts than MDT cases (423.4 vs. 385.8 g) and were more likely to have cardiomegaly (37.1 vs. 20.4%) and replacement fibrosis (25.7 vs. 14.5%). The clinical picture was of a sudden cardiac event in a middle-aged man with a high methamphetamine concentration. Cardiovascular signs of heavy methamphetamine use are frequently seen.
法医病理学家对仅归因于甲基苯丙胺毒性（MT，n = 93）的死亡特征进行了检查，并与多药毒性（MDT，n = 634）病例进行了比较。MT病例的平均年龄为36.7岁，86.0%为男性。报告有剧烈活动的占12.9%。最常见的目击者观察结果是：虚脱（60.3%）、呼吸困难（36.2%）和体温过高（27.6%）。MT病例的血液中甲基苯丙胺（0.54 vs. 0.11 mg/L）和苯丙胺（0.04 vs. 0.02 mg/L）浓度较高，而使用阿片类药物（12.5% vs. 80.9%）、催眠镇静剂（27.3 vs. 60.7%）、抗抑郁药（14.8 vs. 29.8%）和抗精神病药（9.1 vs. 19.7%）的可能性较低。MT病例的心脏明显比MDT病例重（423.4 vs. 385.8 g），并且更有可能出现心脏肥大（37.1 vs. 20.4%）和替代性纤维化（25.7 vs. 14.5%）。临床表现为一名中年男性突发心脏事件，甲基苯丙胺浓度较高。大量使用甲基苯丙胺的心血管体征很常见。
