Lewis D E, Moore C M, Leikin J B, Koller A
United States Drug Testing Laboratory, Chicago, Illinois, USA.
J Anal Toxicol. 1995 May-Jun;19(3):148-50. doi: 10.1093/jat/19.3.148.
We established the validity of a drug-screening method to detect the presence of cocaine or benzoylecgonine or both in meconium and then undertook an analysis of results from urine and meconium specimens obtained concurrently from neonates within 3 days of birth. Meconium specimens from 82 consecutive newborns were analyzed using fluorescence polarization immunoassay (FPIA), Kinetic Interaction of Microparticles in Solution (KIMS), and gas chromatography-mass spectrometry (GC-MS). Each meconium specimen was analyzed by all three methods. Fifty-four paired urine and meconium specimens were obtained over a 13-month period from a neonatal intensive care unit. Urine drug testing was performed by immunoassay (enzyme multiplied immunoassay [EMIT] technique), whereas meconium specimens utilized FPIA with GC-MS confirmation on all but one specimen (due to insufficient quantity). Ten true positives were found by GC-MS, 10 positives were found by FPIA, and 70 positives were found by KIMS. Of the 54 paired samples, 39 samples tested negative for cocaine in both urine and meconium; four specimens were positive by both routes; 10 specimens were negative in urine but positive in the meconium; and one specimen tested positive in urine but negative in the meconium. Thus, 9.3% of the urine specimens tested positive, and 25.9% of meconium samples tested positive (p = .011; McNemar's Test). We conclude that screening meconium specimens by FPIA followed by GC-MS confirmation of screened positives yields highly accurate determinations of the presence of cocaine or benzoylecgonine or both in meconium and that testing of meconium for cocaine and its metabolites is more sensitive than testing of urine.
我们确立了一种药物筛查方法的有效性，该方法用于检测胎粪中可卡因或苯甲酰爱康宁或两者的存在，然后对出生后3天内同时采集的新生儿尿液和胎粪样本的检测结果进行了分析。使用荧光偏振免疫分析法（FPIA）、溶液中微粒的动力学相互作用法（KIMS）和气相色谱-质谱联用法（GC-MS）对82例连续新生儿的胎粪样本进行了分析。每个胎粪样本均采用这三种方法进行分析。在13个月的时间里，从新生儿重症监护病房获取了54对尿液和胎粪样本。尿液药物检测采用免疫分析法（酶放大免疫分析法[EMIT]技术），而胎粪样本除一个样本（因数量不足）外，均采用FPIA法并以GC-MS法进行确认。通过GC-MS法发现10例假阳性，通过FPIA法发现10例假阳性，通过KIMS法发现70例假阳性。在54对样本中，39对样本的尿液和胎粪中可卡因检测均为阴性；4个样本在两种检测途径中均呈阳性；10个样本尿液检测为阴性但胎粪检测为阳性；1个样本尿液检测为阳性但胎粪检测为阴性。因此，9.3%的尿液样本检测呈阳性，25.9%的胎粪样本检测呈阳性（p = 0.011；McNemar检验）。我们得出结论，采用FPIA法筛查胎粪样本，随后用GC-MS法对筛查出的阳性样本进行确认，能够高度准确地测定胎粪中可卡因或苯甲酰爱康宁或两者的存在，并且对胎粪中可卡因及其代谢物的检测比尿液检测更敏感。
