一名15个月大儿童尿液中的Δ-9-四氢大麻酚酸A（THC-A）：病例报告。

Delta-9-tetrahydrocannabinolic acid A (THC-A) in urine of a 15-month-old child: A case report.

作者信息

Morini Luca, Quaiotti Jessica, Moretti Matteo, Osculati Antonio Marco Maria, Tajana Luca, Groppi Angelo, Vignali Claudia

机构信息

Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini 12, 27100 Pavia, Italy.

出版信息

Forensic Sci Int. 2018 May;286:208-212. doi: 10.1016/j.forsciint.2018.03.020. Epub 2018 Mar 19.

DOI:10.1016/j.forsciint.2018.03.020

PMID:29602148

Abstract

INTRODUCTION

The acidic forms of cannabinoids, THC-A and CBD-A are naturally present in cannabis plants and preparations and are generally decarboxylated to the active compounds before the use (e.g. thermally decarboxylated through smoking). Hence, the identification of the acidic compounds in urine could be an evidence of cannabis ingestion rather than a passive exposure to smoke. This case report described a 15-month-old child that suffered an acute intoxication by accidental cannabis ingestion. It is important to assess the ingestion and to discriminate it from a passive exposure to better interpret the clinical findings and to establish the correct therapeutic procedure.

METHODS

Urine samples were simply diluted in deionized water and directly injected in the LC-MS/MS system. D-THCCOOH was used as internal standard. Chromatographic separation of THCCOOH, THC-A and CBD-A was carried out in reversed phase on a c18 column. A triple quad in MRM negative mode was used to monitor the three analytes.

RESULTS AND DISCUSSION

The developed LC-MS/MS method was simple and fast. A LOD of 3.0ng/mL and a LOQ of 10.0ng/mL were measured for the three compounds. The analytical procedure was validated accordingly to international guidelines. The two urine samples collected from the 15-month-old child at the hospitalization and after three days provided positive results for THCCOOH (130.0 and 10.0ng/mL respectively). THC-A was found only in the urine sample collected at the hospitalization (concentration: 70.0ng/mL).

CONCLUSION

THC-A was detected and quantitated in a urine sample of a 15-month-old child.

摘要

引言

大麻素的酸性形式，如四氢大麻酚酸（THC-A）和大麻二酚酸（CBD-A）天然存在于大麻植物及其制品中，通常在使用前脱羧转化为活性化合物（例如通过吸烟进行热脱羧）。因此，尿液中酸性化合物的鉴定可能是摄入大麻的证据，而非被动接触烟雾。本病例报告描述了一名15个月大的儿童因意外摄入大麻而发生急性中毒。评估摄入量并将其与被动接触区分开来，对于更好地解释临床发现和确立正确的治疗程序非常重要。

方法

尿液样本简单地用去离子水稀释后直接注入液相色谱-串联质谱（LC-MS/MS）系统。以D-四氢大麻酚羧酸（D-THCCOOH）作为内标。在反相条件下于C18柱上对四氢大麻酚羧酸（THCCOOH）、四氢大麻酚酸（THC-A）和大麻二酚酸（CBD-A）进行色谱分离。采用三重四极杆质谱仪在多反应监测（MRM）负离子模式下监测这三种分析物。

结果与讨论

所建立的LC-MS/MS方法简便快速。三种化合物的检测限（LOD）为3.0ng/mL，定量限（LOQ）为10.0ng/mL。该分析程序按照国际指南进行了验证。从该15个月大儿童住院时及三天后采集的两份尿液样本中，四氢大麻酚羧酸（THCCOOH）检测结果呈阳性（分别为130.0和10.0ng/mL）。仅在住院时采集的尿液样本中发现了四氢大麻酚酸（THC-A）（浓度：70.0ng/mL）。