Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, University of Linköping, Linköping SE-58183, Sweden.
J Anal Toxicol. 2024 Mar 28;48(3):131-140. doi: 10.1093/jat/bkae008.
This article traces the origin of various charts and tables delineating the stages of alcohol influence in relation to the clinical signs and symptoms of drunkenness and a person's blood-alcohol concentration (BAC). In forensic science and legal medicine, the most widely used such table was created by Professor Kurt M. Dubowski (University of Oklahoma). The first version of the Dubowski alcohol table was published in 1957, and minor modifications appeared in various articles and book chapters until the final version was published in 2012. Seven stages of alcohol influence were identified including subclinical (sobriety), euphoria, excitement, confusion, stupor, alcoholic coma and death. The BAC causing death was initially reported as 0.45+ g%, although the latest version cited a mean and median BAC of 0.36 g% with a 90% range from 0.21 g% to 0.50 g%. An important feature of the Dubowski alcohol table was the overlapping ranges of BAC for each of the stages of alcohol influence. This was done to reflect variations in the physiological effects of ethanol on the nervous system between different individuals. Information gleaned from the Dubowski table is not intended to apply to any specific individual but more generally for a population of social drinkers, not regular heavy drinkers or alcoholics. Under real-world conditions, much will depend on a person's age, race, gender, pattern of drinking, habituation to alcohol and the development of central nervous tolerance. The impairment effects of ethanol also depend to some extent on whether observations are made on the rising or declining phase of the blood-alcohol curve (Mellanby effect). There will always be some individuals who do not exhibit the expected behavioral impairment effects of ethanol, such as regular heavy drinkers and those suffering from an alcohol use disorder.
本文追溯了各种图表和表格的起源，这些图表和表格描绘了酒精影响与醉酒的临床体征和症状以及一个人血液中的酒精浓度 (BAC) 之间的关系。在法医学和法医学中，使用最广泛的表是由俄克拉荷马大学的库尔特·M·杜博夫斯基教授创建的。杜博夫斯基酒精表的第一个版本于 1957 年发表，此后在各种文章和书章节中出现了一些小的修改，直到 2012 年最终版本发表。确定了七个酒精影响阶段，包括亚临床（清醒）、欣快、兴奋、混乱、昏迷、酒精昏迷和死亡。导致死亡的 BAC 最初报告为 0.45+g%，尽管最新版本引用的平均和中位数 BAC 为 0.36g%，90%的范围为 0.21g%至 0.50g%。杜博夫斯基酒精表的一个重要特点是每个酒精影响阶段的 BAC 重叠范围。这样做是为了反映不同个体之间乙醇对神经系统的生理影响的变化。从杜博夫斯基表中收集的信息并非旨在适用于任何特定个体，而是更普遍地适用于社交饮酒者群体，而不是经常大量饮酒者或酗酒者。在现实世界的条件下，很多因素将取决于一个人的年龄、种族、性别、饮酒模式、对酒精的习惯化和中枢神经系统耐受性的发展。乙醇的损害效应在某种程度上也取决于观察是在血液酒精曲线的上升还是下降阶段进行（Mellanby 效应）。总会有一些个体不会表现出乙醇预期的行为损害效应，例如经常大量饮酒者和患有酒精使用障碍的个体。
