Preston K L, Huestis M A, Wong C J, Umbricht A, Goldberger B A, Cone E J
National Institute on Drug Abuse Intramural Research Program, Baltimore, Maryland, USA.
J Anal Toxicol. 1999 Sep;23(5):313-22. doi: 10.1093/jat/23.5.313.
Sweat and urine specimens were collected from 44 methadone-maintenance patients to evaluate the use of sweat testing to monitor cocaine use. Paired sweat patches that were applied and removed weekly (on Tuesdays) were compared with 3-5 consecutive urine specimens collected Mondays, Wednesdays, and Fridays. All patches (N = 930) were extracted in 2.5 mL of solvent and analyzed by ELISA immunoassay (cutoff concentration 10 ng/mL); a subset of patches (N = 591) was also analyzed by gas chromatography-mass spectrometry (GC-MS) for cocaine, benzoylecgonine (BZE), and ecgonine methyl ester (EME) (cutoff concentration 5 ng/mL). Urine specimens were subjected to qualitative analysis by EMIT (cutoff 300 ng/mL) and subsets were analyzed by TDx (semiquantitative, LOD 30 ng/mL) and by GC-MS for cocaine (LOD 5 ng/mL). Results were evaluated to (1) determine the relative amounts of cocaine and its metabolites in sweat; (2) assess replicability in duplicate patches; (3) compare ELISA and GC-MS results for cocaine in sweat; and (4) compare the detection of cocaine use by sweat and urine testing. Cocaine was detected by GC-MS in 99% of ELISA-positive sweat patches; median concentrations of cocaine, BZE, and EME were 378, 78.7, and 74 ng/mL, respectively. Agreement in duplicate patches was approximately 90% by ELISA analysis. The sensitivity, specificity, and efficiency of sweat ELISA cocaine results as compared with sweat GC-MS results were 93.6%, 91.3%, and 93.2%, respectively. The sensitivity, specificity, and efficiency between ELISA sweat patch and EMIT urine results were 97.6%, 60.5%, and 77.7%, respectively. These results support the use of sweat patches for monitoring cocaine use, though further evaluation is needed.
收集了44名美沙酮维持治疗患者的汗液和尿液样本，以评估汗液检测在监测可卡因使用方面的应用。将每周（周二）应用并取下的配对汗液贴片与周一、周三和周五收集的3 - 5份连续尿液样本进行比较。所有贴片（N = 930）均在2.5 mL溶剂中提取，并通过酶联免疫吸附测定（ELISA）免疫分析法进行分析（临界浓度10 ng/mL）；一部分贴片（N = 591）还通过气相色谱 - 质谱联用仪（GC - MS）分析可卡因、苯甲酰爱康宁（BZE）和芽子碱甲酯（EME）（临界浓度5 ng/mL）。尿液样本通过酶放大免疫测定技术（EMIT）进行定性分析（临界值300 ng/mL），部分样本通过荧光偏振免疫分析法（TDx）进行分析（半定量，检测限30 ng/mL），并通过GC - MS分析可卡因（检测限5 ng/mL）。对结果进行评估以：（1）确定汗液中可卡因及其代谢物的相对含量；（2）评估重复贴片的可重复性；（3）比较汗液中可卡因的ELISA和GC - MS结果；（4）比较汗液检测和尿液检测对可卡因使用的检测情况。通过GC - MS在99%的ELISA阳性汗液贴片中检测到可卡因；可卡因、BZE和EME的中位浓度分别为378、78.7和74 ng/mL。通过ELISA分析，重复贴片中的一致性约为90%。与汗液GC - MS结果相比，汗液ELISA可卡因结果的敏感性、特异性和效率分别为93.6%、91.3%和93.2%。ELISA汗液贴片与EMIT尿液结果之间的敏感性、特异性和效率分别为97.6%、60.5%和77.7%。这些结果支持使用汗液贴片监测可卡因使用，不过仍需要进一步评估。
