Ikematsu Natsuki, Kashiwagi Masayuki, Hara Kenji, Waters Brian, Matsusue Aya, Takayama Mio, Kubo Shin-Ichi
Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, 814-0180 Fukuoka, Japan.
Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, 814-0180 Fukuoka, Japan.
Leg Med (Tokyo). 2018 Sep;34:27-35. doi: 10.1016/j.legalmed.2018.08.003. Epub 2018 Aug 6.
In some forensic autopsy cases there are high concentrations of p-cresol in the blood. In vivo, p-cresol is the only isomer yielded by intestinal bacteria and is excreted into urine. We investigated the diagnostic meaning of p-cresol in the blood of forensic autopsy cases. Blood samples from 110 autopsy cases within 48 h of the postmortem interval (PMI) and 10 healthy adults were examined. Blood with p-cresol-d as an internal standard was analyzed using a GC-MS/MS method. Using acid and heat deproteinization, free (F) and conjugated (non-protein bound: C; protein bound: PC) p-cresol were individually analyzed. The p-cresol concentrations were 1.39 ± 0.86 µg/ml [mean ± SD] and 1.18 (0.19-18.80) µg/ml [median (range)] in healthy adults and autopsy cases, respectively. The p-cresol showed no significant relationship to age, sex, fasting duration, survival duration, or PMI. No significant differences were found between causes of death. Significantly higher levels of C p-cresol were found in cases with atherosclerosis in the basilar or renal arteries, or stenosis in the coronary artery. Significantly higher levels of p-cresol except F were found in cases with hyalinosis of the kidney. Cases with low BMI also showed significantly higher p-cresol concentrations. The 22 cases of abnormally high total p-cresol were investigated. It was considered that high concentrations of p-cresol could be an indicator of certain diseases and physical conditions that effect the production, absorption, metabolism, circulation, and excretion of p-cresol. Measuring the levels of p-cresol may provide valuable information about the antemortem physical conditions.
在一些法医尸检案例中，血液中对甲酚浓度很高。在体内，对甲酚是肠道细菌产生的唯一异构体，并排泄到尿液中。我们研究了法医尸检案例血液中对甲酚的诊断意义。对死后间隔（PMI）48小时内的110例尸检案例和10名健康成年人的血样进行了检测。以氘代对甲酚为内标，采用气相色谱-串联质谱法分析血液。通过酸和热去蛋白处理，分别分析游离（F）和结合（非蛋白结合：C；蛋白结合：PC）对甲酚。健康成年人和尸检案例中对甲酚浓度分别为1.39±0.86µg/ml[平均值±标准差]和1.18（0.19 - 18.80）µg/ml[中位数（范围）]。对甲酚与年龄、性别、禁食时间、存活时间或PMI均无显著关系。不同死因之间未发现显著差异。在基底动脉或肾动脉有动脉粥样硬化或冠状动脉狭窄的案例中，发现结合型对甲酚水平显著升高。在肾透明变性的案例中，除游离型外的对甲酚水平显著升高。低体重指数的案例也显示对甲酚浓度显著升高。对22例总对甲酚异常高的案例进行了调查。认为高浓度对甲酚可能是影响对甲酚产生、吸收、代谢、循环和排泄的某些疾病和身体状况的指标。测量对甲酚水平可能为生前身体状况提供有价值的信息。
