Denmark L N
Office of the Chief Medical Examiner, Edmonton, Alberta, Canada.
Forensic Sci Int. 1993 Dec;62(3):225-32. doi: 10.1016/0379-0738(93)90211-r.
The purpose of this study was to determine if the ketone body beta-hydroxybutyrate (beta-HBA) is a useful positive marker for sudden deaths in chronic alcoholics, thought to be due to hypoglycemia. Beta-HBA can be reliably measured in postmortem samples of vitreous humour and urine. In fatalities where there is a history of chronic alcoholism and routine investigations, including autopsy and routine toxicology, yield only a fatty liver as positive findings, a raised level of beta-HBA can be used as an indicator for alcoholic ketosis. Alcoholic ketosis is often associated with antemortem hypoglycemia. Caution should be observed in attributing the significance of ketosis exclusively to alcohol in those conditions where it would otherwise be expected (i.e. diabetic ketoacidosis and chronic starvation). A measurement of this marker of alcoholic ketosis may also help in the investigation of cases where hypothermia or alcohol withdrawal fits are suspected.
本研究的目的是确定酮体β-羟基丁酸酯（β-HBA）是否是慢性酒精中毒者猝死的有用阳性标志物，慢性酒精中毒者猝死被认为是由低血糖所致。β-HBA可在玻璃体液和尿液的尸检样本中可靠地检测出来。在有慢性酒精中毒病史且常规检查（包括尸检和常规毒理学检查）仅发现脂肪肝为阳性结果的死亡病例中，β-HBA水平升高可作为酒精性酮症的指标。酒精性酮症常与死前低血糖相关。在那些原本预期会出现酮症的情况（即糖尿病酮症酸中毒和慢性饥饿）下，在将酮症的意义完全归因于酒精时应谨慎。对这种酒精性酮症标志物的检测也可能有助于对怀疑有体温过低或酒精戒断发作的病例进行调查。
