医学课件醇类中毒.ppt

第四章 醇类中毒Spirits intoxicant Forensic department Zufeng wang Spirits intoxicant ↓ ↓ Alcohol intoxication Drugged Driving? Is it a problem? Who’s doing it? How do we prevent it? 概 述 醇类是一类跟链烃基相连的羟基的有机化合物。 甲醇－－醛类－－酸类 乙醇－－醛类－－酮类 法医学中常见 第一节 乙醇中毒 中毒原因： 毒理作用： 中毒致死量： 中毒症状： 尸体检查所见： 检材采取： 法医学鉴定要点： Ethyl alcohol intoxication Any drink containing from 0.5 to 95% alcohol is considered an alcoholic beverage. The term “proof” is used to describe the strength of an alcoholic beverage. Proof is defined as twice the percentage of the alcohol content of the drink. Thus, an 80-proof beverage is 40% alcohol. The alcohol content of beer ranges between 3.2 and 4%, table wines 7.1 to 14%, whiskey 40–75%, vodka 40–50%, gin 40–85%, and rum 40–95%. Alcohol Definition Alcohol tolerance: over time, the person must consume more alcohol to achieve the same effect Dependence: develop withdraw symptoms with cessation of alcohol Addiction: drastic behavior used to maintain alcohol intake, often involved socially inappropriate behavior 酒度：20℃时乙醇含量的百分比表示，即100 ml酒类饮料中含乙醇的毫升数。 啤酒2－6％，葡萄酒10－23％，黄酒14－17％，白酒50－65％，威士忌40－50％，杜松子酒40－55％，朗姆酒40－65％。 化工、医药原料，实验室试剂。 中毒原因 大量饮酒致急性中毒。 过量饮酒可直接中毒或严重并发症。 医疗误用，发生中毒。 与其他药物相互作用。 长期慢性中毒。 乙醇滥用导致一系列社会问题－车祸、打架斗殴、工伤事故、暴力犯罪及意外事故。 毒理作用 吸收： 80%由十二指肠，其余由胃。 酒后2－5分钟开始入血，1小时吸收60％，1.5小时吸收90％，血中浓度达高峰，2.5小时全部吸收。 空腹吸收快（半小时80％），食物（脂肪、蛋白）减慢吸收收，乙醇含量高吸收快，有胃病吸收快。蒸汽可由呼吸道吸入，皮肤少。 ecause alcohol is soluble in water, it is present in the body tissue in direct relation to the amount of water content of the tissue or fluid. Specimens with high water content, such as blood or vitreous, will have high concentrations of alcohol compared with tissues such as the liver or brain. Forensic pathologists tend to deal in whole blood when performing alcohol determinations, while clinicians often use serum or plasma. 毒理作用 分布： 入血后均匀而迅速分布全身所有组织和体液中。酒后1-1.5h血中浓度最高，6-13h脏器最高，血供好的脏器（脑、肝、肾、肺）分布多，脂肪、骨组织分布少。 在平衡状态时，全血与脑、肝、脑 脊液、呼气的乙醇浓度恒定，分别为：1