亚硝酸盐对碳氧血红蛋白饱和度检测影响的实验性研究  

A experimental study on the interference of nitrite in the detection of carboxyhemoglobin saturation

作　　者：沈学博 杭天捷 林彦辰 饶渝兰 王芳琳 栾玉静 王瑞花 廖林川[2] 黄志斌 Shen Xuebo;Hang Tianjie;Lin Yanchen;Rao Yulan;Wang Fanglin;Luan Yujing;Wang Ruihua;Liao Linchuan;Huang Zhibin(Department of Forensic Medicine,School of Basic Medical College,Fudan University,Shanghai 200032,China;West China School of Basic Medical Sciences and Forensic Medicine,Sichuan University,Chengdu 610041,China;Center for Forensic Science of Shanghai Medical College,Fudan University,Shanghai 200032,China;Institute of Forensic Science,Ministry of Public Security,Beijing 100038)

机构地区：[1]复旦大学基础医学院法医学系,上海200032 [2]四川大学基础医学与法医学院,四川成都610041 [3]复旦大学上海医学院司法鉴定中心,上海200032 [4]公安部鉴定中心,北京100038

出　　处：《中国法医学杂志》2024年第2期187-191,共5页Chinese Journal of Forensic Medicine

基　　金：现场物证溯源技术国家工程实验室开放课题(2020NELKFKT06)。

摘　　要：目的研究亚硝酸盐对碳氧血红蛋白饱和度(COHb%)检测的干扰及影响因素,比较紫外-可见分光光度法(UV-VIS)与血气分析法,验证血气分析法能在一定程度减少亚硝酸盐干扰、提高COHb%检测准确性。方法设置不同剂量亚硝酸钠中毒的动物模型,模拟亚硝酸盐中毒的人体血液,对比UV-VIS(包括标准法和还原法)与血气分析法测定血样中的COHb%结果。结果使用UV-VIS检测时,无法区分亚硝酸盐中毒的血液与一氧化碳中毒的血液,由于亚硝酸盐中毒血液的COHb%测定值会显著偏高,易被误判为CO中毒。而使用血气分析法测定时,亚硝酸盐中毒血液中的COHb%数值未升高而高铁血红蛋白饱和度(MetHb%)数值升高,能够反映实际中毒情况。结论与传统的UV-VIS法测定血液中COHb%相比,血气分析法可有效减小亚硝酸盐的干扰。在测定CO时,对疑似亚硝酸盐中毒的检材时应慎重选择检测方法,以免导致错误的鉴定结论。Objective To explore the interference factors of nitrite in the detection of carboxyhemoglobin saturation(COHb%)by Ultraviolet-visible spectroscopy(UV-VIS),compare the UV-VIS method with the blood gas analysis method,and verify that the blood gas analysis method can reduce nitrite interference and improve the accuracy of COHb% determination.Methods Animal models with different doses of sodium nitrite poisoning were established.The results of COHb% determination in the blood samples were compared between UV-VIS(including standard method and reduction method)and blood gas analysis.Results The UV-VIS method failed to differentiate the nitrite poisoning blood from the CO poisoned blood,because nitrite poisoning increased the COHb% value in blood and it was easy to be misdiagnosed as CO poisoning.However,when the blood gas analysis was used,the COHb% value in the blood of nitrite poisoning did not increase but the MetHb% value increased,which could reflect the actual poisoning situation.Conclusion Compared with the traditional UV-VIS method for determining COHb%in blood,blood gas analysis can reduce the interference of nitrite.In the cases of testing CO in blood,the detection method should be carefully selected when the test samples were suspected of nitrite poisoning,so as to avoid incorrect identification conclusions.

关 键 词：法医毒物分析 碳氧血红蛋白饱和度检测 亚硝酸盐 血气分析法 紫外-可见分光光度法 

分 类 号：D918.93[政治法律—法学]