85例药物滥用死亡者的法医鉴定及分析

FORENSIC IDENTIFICATION AND ANALYSIS OF 85 DRUG ABUSE DEATHS

目的··:了解药物滥用死亡尸体病理改变、体内检出药物类型、死亡方式及其它流行特征。方法··:调查与死亡有关的案情 ,现场勘查 ,法医系统尸体解剖 ,生物检材毒物药物分析 ,死亡方式综合推断。结果··:陕西地区1995年 -2001年有85例经法医鉴定为药物滥用死亡 ,其中男63例 ,女22例 ;尸体血液、脏器、毛发内检出的滥用药物70 %是海洛因/吗啡 ;多药混合滥用特点明显 ;最常见的病理变化包括 :多脏器淤血、水肿、出血、小动脉硬化 ,细胞变性、坏死 ,肺内异物及皮肤注射针眼、脓肿等 ;常见合并的传染性疾病依次为 :结核病 (21 % )、肝硬化 (12 % )和病毒性肝炎 (9 % )等 ,AIDS未检出。药物滥用死亡者的平均年龄为33.4a±s8.9a,从滥用到死亡约10年期限;死亡方式以自然死亡最多 (41% ),其次为意外事故 (22 % )。结论·· :药物滥用死亡经法医鉴定的人数呈上升趋势 ,平均死亡年龄小 ,药物滥用造成的脏器损害广泛 ,传染性疾病感染率高 ,易并发意外事故 ,值得关注。

Objective: To observe pathological features, drug types detected in bodies, death manner and epidemic character of drug abuse deaths. Methods: The detail of the death cases and their scene were investigated firstly. Then forensic autopsy, microscopic examination and toxicological analysis were carried out. The manner of death was deduced comprehensively based on all above findings. Results: There were 85 cases determined as drug abuse death in Shaanxi area from Oct. 1995 to Oct. 2001, including 63 males and 22 females. 70% of the subjects detected in postmortem biological samples were heroin /morphine. Hyperaemia, edema, hemorrhage and arteriolar sclerosis of multi-organs; cells denature and necrosis; foreign body in pulmonary, as well as needle puncture tracks on skin and dermapostasis, were common pathological observations. Incidences of tuberculosis(21%),cirrhosis(12%) and hepatitis(9%) were higher than those found in general autopsy population. No AIDS case was found. The average age of drug abuse deaths was 33.4 a±s 8.9a. The subsequent transition to drug addiction with its fatal consequences extends over a ten-year period. Natural death(41%) was the frequent death manner, then accident (22%). Conclusion: The number of drug abuse deaths identified by forensic examination has been increasing in recent years. As young victims, wide-range organ hazard and high incidences of communicative diseases and accidents, drug abuse death should be followed with interest by researchers in different fields in order to develop strategies to counteract this fatality.