Ghaderi Amir, Banafshe Hamid Reza, Khodabandehlo Soroor, Mehrzad Fateme, Mehrpour Omid, Afshari Reza
Ph.D. Student of Addiction Studies, Physiology Research Center, Department of Addiction Studies, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Ph.D. of Pharmacology, Associate Professor, Physiology Research Center, Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Electron Physician. 2017 Apr 25;9(4):4190-4194. doi: 10.19082/4190. eCollection 2017 Apr.
Thallium (Tl), lead and steroid exposures were reported as a result of street drug consumption such as heroin and cocaine.
This study aimed to compare the values of qualitative and quantitative assays for detecting Tl as an adulterant in opioid-like compound drug users.
This case-control study was conducted throughout a specified time bracket ranging from May 2015 to November 2015 in Imam Reza Hospital, Mashhad, Iran. In general, urine thallium samples for 100 opioid overdosed subjects with a history of chronic opioid use and 50 non-drug users were studied. Qualitative 24 hours-urinary-thallium-level (QL) and quantitative 24 hours-urinary-thallium-level (QT) were conducted in both groups. Independent-samples t-test and Spearman's Coefficient were applied for analytical purposes. SPSS software 16 was used to conduct statistical analyses with P values less than 0.05 regarded as significant.
A total of 150 cases were studied. Raw opium users accounted for 66% of the cases followed by mixed (28%) and heroin users (6%). Mean (SD) QT level for QL was 26.8 (1) μg/L, while it was 2.3 μg/L (0.4 μg/L) for negative QL, which was far below QL positive cases (p=0.002). The qualitative test showed more accuracy at higher quantitative levels. In all cases, qualitative test was fully sensitive (100%), highly specific (89%) with a positive likelihood ratio (PLR) of 9.1 and a negative likelihood ratio (NLR) of 0.
These results suggest that qualitative assays could be used with confidence in assessing Tl exposure in drug users. Physicians may easily and confidently use Tl qualitative tests in rehabilitation centers, where toxicology laboratories may not be available.
据报道，吸食海洛因和可卡因等街头毒品会导致铊（Tl）、铅和类固醇暴露。
本研究旨在比较定性和定量检测方法在检测阿片类复方药物使用者中作为掺假剂的铊的价值。
本病例对照研究于2015年5月至2015年11月在伊朗马什哈德伊玛目礼萨医院的特定时间段内进行。总体而言，研究了100名有慢性阿片类药物使用史的阿片类药物过量受试者和50名非吸毒者的尿铊样本。两组均进行了定性24小时尿铊水平（QL）和定量24小时尿铊水平（QT）检测。采用独立样本t检验和Spearman系数进行分析。使用SPSS软件16进行统计分析，P值小于0.05被视为具有统计学意义。
共研究了150例病例。生鸦片使用者占病例的66%，其次是混合药物使用者（28%）和海洛因使用者（6%）。QL的平均（标准差）QT水平为26.8（1）μg/L，而阴性QL的QT水平为2.3μg/L（0.4μg/L），远低于QL阳性病例（p = 0.002）。定性检测在较高定量水平时显示出更高的准确性。在所有病例中，定性检测的敏感性为100%，特异性为89%，阳性似然比（PLR）为9.1，阴性似然比（NLR）为0。
这些结果表明，定性检测可用于可靠地评估吸毒者的铊暴露情况。在没有毒理学实验室的康复中心，医生可以轻松且放心地使用铊定性检测。
