Pan Meiru, Wang Xin, Zhao Yunli, Liu Wei, Xiang Ping
Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Shanghai, 200063, China; School of Pharmacy, Shenyang Pharmaceutical University, Wenhua Road 103, Shenyang, 110016, China.
Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Shanghai, 200063, China.
Forensic Sci Int. 2019 May;298:39-47. doi: 10.1016/j.forsciint.2019.02.039. Epub 2019 Feb 28.
Knowing the specific pattern of forensic toxicology cases in a region is vital to help the local government establish an effective prevention and treatment system; currently, there have been no published reports investigating various types of forensic toxicology cases based on a large autopsy series and city size. The data in this study were obtained from records kept at the Academy of Forensic Science (AFS) between February 2017 and December 2017, and the cases were mainly from the Public Security Organs People's Police in Shanghai, China. There were 299 autopsies; the leading cause of death was traffic accidents (37.1%), and the manners of death were mainly accidental (54.8%). From a total of 9083 cases, 1992 involved traffic accidents, 6787 were drug abuse, 269 were poisonings, and 35 were drug-facilitated sexual assaults (DFSAs). We also investigated the pattern of unnatural deaths and the alcohol-positive (with a blood alcohol concentration (BAC) ≥0.20 mg/ml) rate among the various cases. The BAC ranged from 0.08 to 7.24 mg/ml in traffic cases, and the mean BAC of the total alcohol-positive drivers was 1.44 mg/ml. It was found that 80.8% of the drivers involved had a BAC ≥ 0.20 mg/ml (limit of civil offense), and 72.8% had a BAC ≥ 0.80 mg/ml (limit of criminal offense). Among the drug abuse cases, there were 4073 cases (60.0%) that were positive for at least one euphoriant; the most frequently abused drug group was amphetamine-type stimulants (ATS). Poisonings by natural toxins (such as scopolamine and tetrodotoxin) account for a significant portion of accidental deaths. Pesticide poisoning was also constituted a large portion, and organophosphorus were the cause of the majority of those cases. Suicide by pesticide showed the highest frequency in the present study. Among the 35 DFSA cases, dexmedetomidine was frequently detected in our study, which has rarely been reported previously in DFSA cases.
了解一个地区法医毒理学案件的具体模式对于帮助当地政府建立有效的预防和治疗体系至关重要；目前，尚无基于大量尸检系列和城市规模对各类法医毒理学案件进行调查的公开报告。本研究的数据来自于2017年2月至2017年12月期间法医学研究院（AFS）保存的记录，这些案件主要来自中国上海公安机关的人民警察。共有299例尸检；主要死因是交通事故（37.1%），死亡方式主要为意外（54.8%）。在总共9083例案件中，1992例涉及交通事故，6787例为药物滥用，269例为中毒，35例为药物辅助性性侵（DFSA）。我们还调查了非自然死亡模式以及各类案件中的酒精阳性（血液酒精浓度（BAC）≥0.20mg/ml）率。交通事故案件中的BAC范围为0.08至7.24mg/ml，所有酒精阳性司机的平均BAC为1.44mg/ml。结果发现，80.8%的涉案司机BAC≥0.20mg/ml（民事违法行为界限），72.8%的司机BAC≥0.80mg/ml（刑事违法行为界限）。在药物滥用案件中，有4073例（60.0%）至少对一种致欣快剂呈阳性；最常被滥用的药物类别是苯丙胺类兴奋剂（ATS）。天然毒素（如东莨菪碱和河豚毒素）中毒在意外死亡中占很大比例。农药中毒也占很大一部分，其中大多数案件是由有机磷引起的。在本研究中，农药自杀的发生率最高。在35例DFSA案件中，右美托咪定在我们的研究中经常被检测到，此前在DFSA案件中很少有报道。
