Nishiguchi M, Kinoshita H, Higasa K, Taniguchi T, Ouchi H, Minami T, Marukawa S, Yoshinaga K, Yamauchi J, Aoki S, Hishida S
Department of Legal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Nihon Hoigaku Zasshi. 2001 Nov;55(3):331-8.
We investigated false-positive reactions obtained from a drug screening test using a Triage panel. We detected 2 cases giving false-positive reaction for AMP (amphetamine, methamphetamine) during the screening of 187 normal subjects. Subsequent follow up testing by high-performance liquid chromatography (HPLC), showed both to be false-positive reactions. As both cases have a history of ingesting the herbal drug, Ma-huang (Ephedra sinica (Ephedraceae)), containing ephedrine, we examined the relationship between false-positive reactions on Triage and Ma-huang. All urine samples collected from 7 healthy volunteers following administration of Ma-huang indicated AMP positive on Triage. Also a high ratio of AMP positives was observed in the patients who were administered Ma-huang-containing drugs at the hospital. However, none of them were identified as true-positives by HPLC or gas chromatography mass spectrometry (GC/MS) analysis. The extract of Ma-huang contained in herbal drugs, which otherwise contain neither amphetamine nor its derivatives, gives (AMP) positive indications on Triage. We speculate that unidentified components of Ma-huang cause the false-positive reactions. We suggest that follow-up tests by GC/MS or HPLC are needed wherever a positive result is obtained from a screening test by Triage. Furthermore, it will be established to continue collecting information on prescribed and non-prescribed drugs.
我们调查了使用Triage检测板进行药物筛查试验时出现的假阳性反应。在对187名正常受试者进行筛查期间，我们检测到2例对苯丙胺（安非他明、甲基苯丙胺）呈假阳性反应的病例。随后通过高效液相色谱法（HPLC）进行的后续检测表明这两例均为假阳性反应。由于这两例都有服用含有麻黄碱的草药麻黄（麻黄科麻黄属植物）的病史，我们研究了Triage检测板上的假阳性反应与麻黄之间的关系。从7名健康志愿者服用麻黄后采集的所有尿液样本在Triage检测中均显示苯丙胺呈阳性。在医院服用含麻黄药物的患者中也观察到较高比例的苯丙胺阳性。然而，通过HPLC或气相色谱 - 质谱联用（GC/MS）分析，这些病例均未被鉴定为真阳性。草药中含有的麻黄提取物，否则既不含苯丙胺也不含其衍生物，但在Triage检测中呈（苯丙胺）阳性。我们推测麻黄中未鉴定的成分导致了假阳性反应。我们建议，无论何时通过Triage筛查试验获得阳性结果，都需要通过GC/MS或HPLC进行后续检测。此外，应持续收集有关处方药和非处方药的信息。
