Moeller Karen E, Lee Kelly C, Kissack Julie C
University of Kansas Medical Center, Kansas City, KS 66160-7231, USA.
Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66.
Drug testing, commonly used in health care, workplace, and criminal settings, has become widespread during the past decade. Urine drug screens have been the most common method for analysis because of ease of sampling. The simplicity of use and access to rapid results have increased demand for and use of immunoassays; however, these assays are not perfect. False-positive results of immunoassays can lead to serious medical or social consequences if results are not confirmed by secondary analysis, such as gas chromatography-mass spectrometry. The Department of Health and Human Services' guidelines for the workplace require testing for the following 5 substances: amphetamines, cannabinoids, cocaine, opiates, and phencyclidine. This article discusses potential false-positive results and false-negative results that occur with immunoassays of these substances and with alcohol, benzodiazepines, and tricyclic antidepressants. Other pitfalls, such as adulteration, substitution, and dilution of urine samples, are discussed. Pragmatic concepts summarized in this article should minimize the potential risks of misinterpreting urine drug screens.
药物检测在医疗保健、工作场所和刑事领域普遍使用，在过去十年中已广泛应用。由于采样方便，尿液药物筛查一直是最常用的分析方法。免疫分析法使用简便且能快速得出结果，这使得其需求和使用量增加；然而，这些检测方法并非完美无缺。如果免疫分析的结果未经气相色谱 - 质谱等二次分析确认，假阳性结果可能会导致严重的医疗或社会后果。美国卫生与公众服务部针对工作场所的指导方针要求对以下5种物质进行检测：苯丙胺、大麻素、可卡因、阿片类药物和苯环己哌啶。本文讨论了这些物质以及酒精、苯二氮䓬类药物和三环类抗抑郁药的免疫分析中可能出现的假阳性和假阴性结果。还讨论了其他陷阱，如尿液样本的掺假、替换和稀释。本文总结的实用概念应能最大限度地降低误解尿液药物筛查结果的潜在风险。
