Kärkelä J T
Department of Anaesthesia, Tampere University Hospital, Finland.
J Forensic Sci. 1993 May;38(3):603-16.
By studying early postmortem changes in cerebrospinal fluid (CSF) it is possible to draw conclusions as to premortem focal brain cell injury and terminal brain ischemia. Cisternal fluid (CF) from 40 different adult cadavers with no known neurological disorder was analyzed and compared with known in vivo values. They were divided into four groups (n = 10 in each group), CF samples taken 2, 4, 10, and 24 h after death. The enzyme activity of CK and CK-BB (EC 2.7.3.2) increased linearly and statistically significantly 4-24 h postmortem (P < 0.001) the 2 h values being already 10 to 20 times higher than in vivo, LD and its isoenzymes 1 to 3 (EC 1.1.1.27) distinctly 10 to 24 h after death. Glucose and pyruvate concentrations in the CF declined, as did Na+ and Cl-. Lactate and K+ increased over time. The earliest statistically significant changes between different timepoints were seen in lactate, pyruvate and K+ concentrations. The GABA concentration was already more than 170 times at 2 h postmortem, and glutamate more than 20 times higher than in vivo. The concentrations of alanine, glycine, lysine, histidine, isoleucine, phenylalanine, and tyrosine were 2 to 3 times higher at 2 h postmortem than during life. The concentrations of all amino acids and ammonia increased linearly and statistically significantly (P < 0.001) in the CF 4 to 24 h postmortem.
通过研究脑脊液（CSF）的早期死后变化，可以得出关于死前局灶性脑细胞损伤和终末期脑缺血的结论。分析了40具无已知神经疾病的不同成年尸体的脑池液（CF），并与已知的体内值进行比较。将它们分为四组（每组n = 10），在死后2、4、10和24小时采集CF样本。死后4 - 24小时，CK和CK - BB（EC 2.7.3.2）的酶活性呈线性增加且具有统计学意义（P < 0.001），2小时的值已经比体内高10到20倍，LD及其同工酶1至3（EC 1.1.1.27）在死后10至24小时明显升高。CF中的葡萄糖和丙酮酸浓度下降，Na +和Cl - 也是如此。乳酸和K +随时间增加。在乳酸、丙酮酸和K +浓度方面，不同时间点之间最早出现具有统计学意义的变化。死后2小时，GABA浓度已经是体内的170倍以上，谷氨酸比体内高20倍以上。死后2小时，丙氨酸、甘氨酸、赖氨酸、组氨酸、异亮氨酸、苯丙氨酸和酪氨酸的浓度比生前高2至3倍。死后4至24小时，CF中所有氨基酸和氨的浓度呈线性增加且具有统计学意义（P < 0.001）。
