Bailey D N
Division of Laboratory Medicine, Department of Pathology, University of California, San Diego 92103-8320, USA.
Am J Clin Pathol. 1996 May;105(5):572-5. doi: 10.1093/ajcp/105.5.572.
Both comprehensive toxicology screening (COM) and limited toxicology screening (LIM) were performed on the same urine in 1,734 consecutive cases over a 6-month period at a university medical center. About half of the screens originated from inpatient services and half from outpatient services (mostly emergency department). In 71 % of the cases, there was agreement between the results of LIM and COM, with 47% of cases being negative. For 500 screens (accounting for 655 individual discrepant findings), at least one discrepancy was noted between LIM and COM. Of these, 399 cases demonstrated at least one finding with COM, but not with LIM ("false-negative" LIM). Topical anesthetics (including cocaine and cocaethylene), antiepileptics, and sympathomimetic amines accounted for 65% of findings. In contrast, 147 cases showed a finding with LIM, but not with COM ("false-positive" LIM), mostly amphetamines. In certain specified clinical circumstances, LIM may be a more cost effective and efficient approach than COM.
在一所大学医学中心的6个月期间，对1734例连续病例的同一份尿液样本进行了全面毒理学筛查（COM）和有限毒理学筛查（LIM）。大约一半的筛查来自住院服务，另一半来自门诊服务（主要是急诊科）。在71%的病例中，LIM和COM的结果一致，其中47%的病例为阴性。在500次筛查中（占655个个体差异结果），LIM和COM之间至少发现了一处差异。其中，399例病例显示COM至少有一项检测结果呈阳性，但LIM未检测到（LIM“假阴性”）。局部麻醉剂（包括可卡因和乙烯基可卡因）、抗癫痫药和拟交感神经胺占这些结果的65%。相比之下，147例病例显示LIM有一项检测结果呈阳性，但COM未检测到（LIM“假阳性”），主要是苯丙胺。在某些特定的临床情况下，LIM可能是一种比COM更具成本效益和效率的方法。
