School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Department of Forensic Medicine, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Leg Med (Tokyo). 2023 May;62:102233. doi: 10.1016/j.legalmed.2023.102233. Epub 2023 Mar 6.
The authors analyzed data from forensic autopsies of 75 patients who died as a result of house fires to clarify the physical factors that affect blood carboxyhemoglobin (COHb) saturation. Blood COHb saturation levels were significantly lower in patients who survived in the hospital. No significant differences were found in the blood COHb saturation levels between patients who died immediately at the scene and those who were pronounced dead at the receiving hospital without heartbeat being restored. The COHb saturation levels were significantly different among the groups of patients classified by the amount of soot. Although age, coronary artery stenosis, and blood alcohol concentration did not significantly affect blood COHb saturation, on comparing patients who died in the same fire, lower COHb saturation was observed in two patients, one with severe coronary artery stenosis and other with severe alcohol intoxication. To accurately interpret blood COHb saturation during forensic autopsy, the heartbeat status (present or absent) at the time of the rescue and the amount of soot in the trachea must be determined. Low levels of COHb saturation may be observed in fatalities with severe coronary atherosclerosis or severe alcohol intoxication.
作者分析了 75 名因房屋火灾死亡的法医解剖患者的数据，以阐明影响血液碳氧血红蛋白（COHb）饱和度的物理因素。在医院幸存的患者血液 COHb 饱和度明显较低。在现场立即死亡的患者和在接收医院宣布死亡且未恢复心跳的患者之间，血液 COHb 饱和度没有差异。根据煤烟量对患者进行分类，血液 COHb 饱和度存在显著差异。虽然年龄、冠状动脉狭窄和血液酒精浓度对血液 COHb 饱和度没有显著影响，但在比较同一火灾中死亡的患者时，发现两名患者的 COHb 饱和度较低，一名患者有严重的冠状动脉狭窄，另一名患者有严重的酒精中毒。为了在法医尸检中准确解读血液 COHb 饱和度，必须确定救援时的心跳状态（存在或不存在）和气管中的煤烟量。在严重冠状动脉粥样硬化或严重酒精中毒的死亡患者中可能会观察到较低的 COHb 饱和度。
