Wang Xinying, Wang Xin, Liu Wei, Chen Hang, Zhang Zhen, Zhao Yunli, Xiang Ping
Department of Pharmaceutical Analysis, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China; Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai, China.
Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai, China.
Leg Med (Tokyo). 2025 Feb;72:102564. doi: 10.1016/j.legalmed.2024.102564. Epub 2024 Dec 19.
Aconitum herbs contain several highly toxic diester-diterpenoid alkaloids, including aconitine, mesaconitine, and hypaconitine. However, finding the cause of death is rather difficult for forensic pathologists during forensic autopsy of aconitine-induced death. Therefore, the ability to determine Aconitum alkaloids is important in these cases. The aim of this study was to review the data for alkaloids in postmortem specimens from 25 aconitine-induced deaths received by the Academy of Forensic Science from 2005 to 2023. Aconitum alkaloids were analyzed using an LC-MS/MS method, which was validated for blood, urine, and liver tissue. Briefly, 0.5 mL (g) of biological sample was subjected to liquid-liquid extraction with diethyl ether at pH 9.2. In 25 aconitine-induced deaths, the blood levels of aconitine, mesaconitine, and hypaconitine were 2.9-470 ng/mL (n = 22), ＜LOQ-30 ng/mL (n = 10), and ＜LOQ-5.0 ng/mL (n = 10), respectively. In some cases, other biological samples (e.g., urine, gastric contents, and liver tissue) and the materials seized on site (e.g., homemade medicinal liquor) were also analyzed. A significant positive correlation was observed between the biological samples and the seized materials for the concentration ratios of aconitine to mesaconitine and of aconitine to hypaconitine. The risk of aconite poisoning is increased by inappropriate administration, including drinking of homemade medicinal liquors containing Aconitum alkaloids, the use of unprocessed or improperly processed Aconitum plant material, and excessive consumption or misuse without doctors' directions. Accidental death caused by misuse of herbal drugs was the main cause of death in the 25 aconitine-induced deaths studied here.
乌头属草药含有多种剧毒的二酯二萜生物碱，包括乌头碱、中乌头碱和次乌头碱。然而，在对乌头碱中毒致死进行法医尸检时，法医病理学家很难确定死因。因此，在这些案件中，测定乌头生物碱的能力很重要。本研究的目的是回顾2005年至2023年法医科学研究院收到的25例乌头碱中毒致死案例的死后标本中生物碱的数据。使用LC-MS/MS方法分析乌头生物碱，该方法已在血液、尿液和肝组织中得到验证。简要地说，取0.5 mL（g）生物样品，用pH 9.2的乙醚进行液液萃取。在25例乌头碱中毒致死案例中，乌头碱、中乌头碱和次乌头碱的血液浓度分别为2.9 - 470 ng/mL（n = 22）、＜LOQ - 30 ng/mL（n = 10）和＜LOQ - 5.0 ng/mL（n = 10）。在某些情况下，还分析了其他生物样品（如尿液、胃内容物和肝组织）以及现场查获的物品（如自制药酒）。在生物样品与查获物品之间，观察到乌头碱与中乌头碱的浓度比以及乌头碱与次乌头碱的浓度比存在显著正相关。不当用药会增加乌头中毒的风险，包括饮用含有乌头生物碱的自制药酒、使用未经加工或加工不当的乌头属植物材料，以及在没有医生指导的情况下过量服用或误用。在这里研究的25例乌头碱中毒致死案例中，误用草药导致的意外死亡是主要死因。
