Wu Jialin, Luan Yujing, Zhang Qingxia, Wang Fanglin, Rao Yulan
Shanghai Key Lab of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice, Shanghai 200063, China.
Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
J Anal Toxicol. 2025 Mar 10;49(3):170-179. doi: 10.1093/jat/bkae096.
Carbon monoxide (CO) is a common gaseous toxin that causes severe poisoning symptoms. Accurate detection of the formation of carboxyhemoglobin (COHb) in the blood is very important for the identification of CO poisoning. In this review, the effects of exogenous toxins, including dichloromethane (DCM), nitrite, and hydrogen sulfide, on the determination of COHb by spectrophotometry are summarized by comparing epidemiological data, case studies, and analytical methods. The mechanism of the effects of these exogenous poisons on COHb detection is described, and the extent of their influence on the clinical diagnosis and forensic identification of CO poisoning is discussed. We suggest that emergency medicine and forensic science practices need to improve the understanding of these toxins and optimize clinical diagnosis and evaluation strategies to address the effects of toxins on the determination of COHb.
一氧化碳（CO）是一种常见的气态毒素，可导致严重的中毒症状。准确检测血液中碳氧血红蛋白（COHb）的形成对于一氧化碳中毒的鉴定非常重要。在本综述中，通过比较流行病学数据、案例研究和分析方法，总结了包括二氯甲烷（DCM）、亚硝酸盐和硫化氢在内的外源性毒素对分光光度法测定碳氧血红蛋白的影响。描述了这些外源性毒物对碳氧血红蛋白检测的作用机制，并讨论了它们对一氧化碳中毒临床诊断和法医鉴定的影响程度。我们建议急诊医学和法医学实践需要提高对这些毒素的认识，并优化临床诊断和评估策略，以应对毒素对碳氧血红蛋白测定的影响。
