ARUP Laboratories, Inc., Salt Lake City, UT 84108, USA.
J Anal Toxicol. 2012 Mar;36(2):81-7. doi: 10.1093/jat/bkr020.
Patterns of buprenorphine and metabolites were examined in 1946 positive urine samples analyzed by liquid chromatography-tandem mass spectrometry for free (unconjugated) buprenorphine and norbuprenorphine (quantitative, 2 to 1000 ng/mL) and buprenorphine-glucuronide (B3G) and norbuprenorphine-glucuronide (N3G) (semi-quantitative, 5 to 1000 ng/mL). Two distribution patterns predominated with 49.1% positive for norbuprenorphine, B3G, and N3G and 41.6% positive for buprenorphine, norbuprenorphine, B3G, and N3G. Buprenorphine, positive in 45.5% of samples, was mostly < 5 ng/mL (median 6.1 ng/mL), but 9.8% were > 1000 ng/mL. Norbuprenorphine, B3G, and N3G had semi-Gaussian distributions with medians of 64.7, 108, and 432 ng/mL, respectively. With buprenorphine < 100 ng/mL (767 samples) or ≥ 100 ng/mL (19 quantifiable samples), the respective median metabolic ratios (free norbuprenorphine/free buprenorphine) were 25.0 and 0.15. In 12 retested "> 1000 ng/mL" buprenorphine samples, free buprenorphine was 4160 to 39,400 ng/mL and free naloxone 2140 to 9560 ng/mL. In 87 subsequent samples with buprenorphine < 20 ng/mL, naloxone concentrations were < 50 ng/mL. Concentrations of buprenorphine > 100 ng/mL (particularly with low metabolite concentrations) are suspect of urine adulteration with medication (4% in the database) that can be checked in most cases by concurrent analysis for naloxone.
对通过液相色谱-串联质谱法分析的 1946 份阳性尿液样本进行了丁丙诺啡及其代谢物的检测，这些样本检测的是游离（未结合）丁丙诺啡和去甲丁丙诺啡（定量，2 至 1000ng/mL）以及丁丙诺啡-葡糖苷酸（B3G）和去甲丁丙诺啡-葡糖苷酸（N3G）（半定量，5 至 1000ng/mL）。两种分布模式占主导地位，其中 49.1%的样本阳性检测出去甲丁丙诺啡、B3G 和 N3G，41.6%的样本阳性检测出丁丙诺啡、去甲丁丙诺啡、B3G 和 N3G。45.5%的样本检测出丁丙诺啡，其含量大多<5ng/mL（中位数 6.1ng/mL），但 9.8%的样本>1000ng/mL。去甲丁丙诺啡、B3G 和 N3G 呈半高斯分布，中位数分别为 64.7、108 和 432ng/mL。丁丙诺啡<100ng/mL（767 个样本）或≥100ng/mL（19 个可定量样本）时，游离去甲丁丙诺啡/游离丁丙诺啡的代谢比值分别为 25.0 和 0.15。在 12 个复测的“>1000ng/mL”丁丙诺啡样本中，游离丁丙诺啡含量为 4160 至 39400ng/mL，游离纳洛酮含量为 2140 至 9560ng/mL。在 87 个随后的丁丙诺啡<20ng/mL 的样本中，纳洛酮浓度<50ng/mL。丁丙诺啡浓度>100ng/mL（特别是代谢物浓度较低时）怀疑尿液中存在药物掺假（数据库中占 4%），在大多数情况下可以通过同时分析纳洛酮进行检查。
