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电击武器与横纹肌溶解症。

Electrical weapons and rhabdomyolysis.

机构信息

University of Minnesota, Box 23, Crystal Bay, MN, 55323, USA.

Leeds Inst. of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK.

出版信息

Forensic Sci Med Pathol. 2021 Mar;17(1):58-63. doi: 10.1007/s12024-020-00311-7. Epub 2020 Sep 18.

Abstract

It has been suggested that an application of a conducted electrical weapon (CEW) might cause muscle injury such as rhabdomyolysis and an acute inflammatory response. We explored this hypothesis by testing the effects of electrical weapons on circulating markers of inflammation and muscle damage. In a prospective study, 29 volunteers received a full-trunk 5-s TASER® X26(E) CEW exposure. Venous blood samples were taken before, 5 min after, and at 24 h following the discharge. We tested for changes in serum levels of C-reactive protein (CRP), alkaline phosphatase (ALP), myoglobin, albumin, globulin, albumin/globulin ratio, aspartate and alanine aminotransferase, creatine kinase, total protein, bilirubin, and lactic acid dehydrogenase. Uncorrected CRP and myoglobin levels were lower in the immediate post exposure period (CRP levels 1.44 ± 1.39 v 1.43 ± 1.32 mg/L; p = 0.046 and myoglobin 36.8 ± 11.9 v 36.1 ± 13.9 μg/L; p = 0.0019) but these changes were not significant after correction for multiple comparisons. There were no changes in other biomarkers. At 24 h, CRP levels had decreased by 30% to 1.01 ± 0.80 mg/L (p = 0.001 from baseline). ALP was unchanged immediately after the CEW application but was reduced by 5% from baseline (66.2 ± 16.1 to 62.7 ± 16.1 IU/L; p = 0.0003) at 24 h. No other biomarkers were different from baseline at 24 h. A full-trunk electrical weapon exposure did not lead to clinically significant changes in the acute phase protein levels or changes in measures of muscle cellular injury. We found no biomarker evidence of rhabdomyolysis.

摘要

有人提出,应用电击枪(CEW)可能会导致肌肉损伤,如横纹肌溶解和急性炎症反应。我们通过测试电击枪对炎症和肌肉损伤循环标志物的影响来探索这一假设。在一项前瞻性研究中,29 名志愿者接受了全胸 5 秒 TASER® X26(E) CEW 暴露。在放电前、放电后 5 分钟和 24 小时采集静脉血样本。我们测试了血清中 C 反应蛋白(CRP)、碱性磷酸酶(ALP)、肌红蛋白、白蛋白、球蛋白、白蛋白/球蛋白比值、天门冬氨酸和丙氨酸氨基转移酶、肌酸激酶、总蛋白、胆红素和乳酸脱氢酶的变化。未校正的 CRP 和肌红蛋白水平在暴露后即刻降低(CRP 水平 1.44±1.39 比 1.43±1.32mg/L;p=0.046 和肌红蛋白 36.8±11.9 比 36.1±13.9μg/L;p=0.0019),但经多次比较校正后无显著差异。其他生物标志物没有变化。24 小时时,CRP 水平下降 30%至 1.01±0.80mg/L(与基线相比,p=0.001)。CEW 应用后 ALP 立即无变化,但从基线降低 5%(66.2±16.1 比 62.7±16.1IU/L;p=0.0003)24 小时时。其他生物标志物与 24 小时时无差异。全胸电击枪暴露不会导致急性期蛋白水平发生临床显著变化,也不会导致肌肉细胞损伤的变化。我们没有发现横纹肌溶解的生物标志物证据。

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