Brookoff D, Rotondo M F, Shaw L M, Campbell E A, Fields L
Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, USA.
Ann Emerg Med. 1996 Mar;27(3):316-20. doi: 10.1016/s0196-0644(96)70266-4.
To determine the presence of cocaethylene, an active metabolite of the combination of cocaine and ethanol, among trauma patients who test positive for cocaine.
We assembled a case series of 416 consecutive urban trauma center patients with major trauma. Urine was tested for the presence of the cocaine metabolite benzoylecgonine. Plasma was quantitatively assayed for cocaine, ethanol, and cocaethylene.
Of the study subjects, 158 (38%) were positive for benzoylecgonine. Of the 114 of these subjects who had adequate plasma specimens, 68 (60%) tested positive for cocaethylene (mean, 41 +/- 27 ng/mL; range, 3 to 213 ng/mL), all tested positive for cocaine (mean, 92.9 +/- 52 ng/mL), and 56% were positive for ethanol (mean, 175 +/- 85 mg/mL). We found poor correlation between admission levels of cocaethylene and cocaine (R=.02), even when subjects were stratified by ethanol level. The correlation between cocaethylene and ethanol levels was weak (R=.24). Of the 68 patients who tested positive for cocaethylene, 29% tested negative for ethanol. Plasma was also assayed from 94 subjects who tested negative for benzoylecgonine; 9% had detectable levels of cocaine, and 2% had detectable levels of cocaethylene.
Cocaethylene was present in more than half of the subjects who tested positive for cocaine.
确定在可卡因检测呈阳性的创伤患者中是否存在可卡因乙烯酯（可卡因和乙醇结合后的一种活性代谢产物）。
我们收集了连续416例城市创伤中心的严重创伤患者组成的病例系列。检测尿液中可卡因代谢产物苯甲酰爱康宁的存在情况。对血浆中的可卡因、乙醇和可卡因乙烯酯进行定量分析。
在研究对象中，158例（38%）苯甲酰爱康宁检测呈阳性。在这些对象中有114例有足够的血浆标本，其中68例（60%）可卡因乙烯酯检测呈阳性（平均为41±27纳克/毫升；范围为3至213纳克/毫升），所有患者可卡因检测均呈阳性（平均为92.9±52纳克/毫升），56%的患者乙醇检测呈阳性（平均为175±85毫克/毫升）。我们发现，即使根据乙醇水平对受试者进行分层，入院时可卡因乙烯酯水平与可卡因水平之间的相关性也很差（R = 0.02）。可卡因乙烯酯与乙醇水平之间的相关性较弱（R = 0.24）。在68例可卡因乙烯酯检测呈阳性的患者中，29%的患者乙醇检测呈阴性。我们还对94例苯甲酰爱康宁检测呈阴性的受试者的血浆进行了分析；9%的受试者可卡因水平可检测到，2%的受试者可卡因乙烯酯水平可检测到。
在可卡因检测呈阳性的受试者中，超过一半的人存在可卡因乙烯酯。
