Williams K R, Pounder D J
Department of Forensic Medicine, University of Dundee, Scotland.
Am J Forensic Med Pathol. 1997 Sep;18(3):246-50. doi: 10.1097/00000433-199709000-00004.
The homogeneity of drug concentrations in skeletal muscle was assessed in eight fatal overdoses. Ten to 30 random samples were taken from leg muscle weighing 1,650 to 7,985 g. For cases involving paracetamol the mean muscle-to-blood ratio ranged from 0.1 to 1.1 (n = 4) for amitriptyline 1.1 to 3.6 (n = 3), and for dothiepin 0.8 to 2.1 (n = 2). The coefficient of variance was large for all drugs, ranging from 10.5 (carbamazepine) to 50 (thioridazine). Skeletal muscle is not homogeneous with respect to drug concentrations in fatal overdose cases. Of 16 instances of drug detection in blood 2 (nortriptyline and promethazine) were not detected in muscle. Muscle-to-blood drug ratios varied significantly among cases, possibly influenced by survival time after drug ingestion. Quantitative interpretations of muscle drug levels present significant difficulties. However, skeletal muscle can be used for qualitative corroboration of blood analyses and is a suitable specimen for drug detection where none other is available.
在八例致命过量用药案例中评估了骨骼肌中药物浓度的均匀性。从重1650至7985克的腿部肌肉中随机采集了10至30个样本。对于涉及对乙酰氨基酚的案例，肌肉与血液的平均比值在0.1至1.1之间（n = 4）；阿米替林为1.1至3.6（n = 3）；多塞平为0.8至2.1（n = 2）。所有药物的变异系数都很大，范围从10.5（卡马西平）到50（硫利达嗪）。在致命过量用药案例中，骨骼肌在药物浓度方面并非均匀一致。在血液检测出药物的16例中，有2例（去甲替林和异丙嗪）在肌肉中未检测到。案例之间肌肉与血液的药物比值差异显著，可能受服药后存活时间的影响。对肌肉药物水平进行定量解读存在重大困难。然而，骨骼肌可用于对血液分析进行定性确证，并且在没有其他可用样本时是适合进行药物检测的标本。
