Graduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Departments of Oral Biology and Pediatric Dentistry, University of Pittsburgh, Pittsburgh, PA, USA.
Crit Rev Toxicol. 2020 Apr;50(4):348-358. doi: 10.1080/10408444.2020.1751062. Epub 2020 Apr 28.
Urine has been a biological matrix of choice for drug screening, but recent advances in technology and the introduction of commercial oral fluid assays have effectively established oral fluid as a viable alternative matrix. This systematic review aimed to evaluate the sensitivity of oral fluid in detecting some illicit drugs compared to urine, and to compare the initial and final detection times of these drugs in both fluids. The electronic search in MEDLINE, Cochrane Library, Scopus, and Web of Science was carried out covering studies published from January 2003 and June 2019, in order to find all valid studies that detected drugs in oral fluid and urine in the same patient. Studies about illicit drugs, such as tetrahydrocannabinol, cocaine, amphetamines and illicit opioids, with fluids collection at the same day, controlled drug administration during the study, reported administration interval and time of collection were favored. Out of 2598 studies identified by electronic search, 7 studies were selected for qualitative analysis. Five were clinical trials and 2 were crossover trials. In total, 74 patients aged 20-52 years underwent a diagnostic examination (4 studies with tetrahydrocannabinol, 1 with methamphetamine, and 2 with cocaine) after drug administration. Illicit drug detection in oral fluid is similar to urine but oral fluid has a strong potential for the immediate detection of recent marijuana use compared to urine. In relation to cocaine and methamphetamine, the largest drugs detection window is obtained through urine analysis. Oral fluids cannot replace urine for most of the purposes of drug testing.
尿液一直是药物筛选的首选生物基质，但最近技术的进步和商业口服液检测试剂盒的引入已有效地确立了口服液作为一种可行的替代基质。本系统评价旨在评估与尿液相比，口服液检测某些非法药物的灵敏度，并比较这两种液体中这些药物的初始和最终检测时间。对 MEDLINE、Cochrane 图书馆、Scopus 和 Web of Science 中的电子检索进行了评估，检索时间覆盖 2003 年 1 月至 2019 年 6 月发表的所有研究，以便找到所有在同一患者中同时检测口服液和尿液中药物的有效研究。研究对象为四氢大麻酚、可卡因、苯丙胺和非法阿片类药物等非法药物，且采集的体液为同一日，在研究过程中受控药物管理，报告药物使用间隔和采集时间。通过电子检索共识别出 2598 项研究，其中有 7 项研究被选中进行定性分析。其中 5 项为临床试验，2 项为交叉试验。总共有 74 名年龄在 20-52 岁的患者在药物使用后进行了诊断检查（4 项研究涉及四氢大麻酚，1 项研究涉及甲基苯丙胺，2 项研究涉及可卡因）。与尿液相比，口服液对近期大麻使用的即时检测具有更强的潜力，但其对非法药物的检测结果与尿液相似。在涉及可卡因和甲基苯丙胺时，通过尿液分析可获得最大的药物检测窗口。对于大多数药物检测目的而言，口服液不能替代尿液。
