Poklis A, Edinboro L E, Lee J S, Crooks C R
Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0165, USA.
J Toxicol Clin Toxicol. 1997;35(1):77-82. doi: 10.3109/15563659709001169.
The sensitivity and selectivity of a colloidal metal immunoassay device (Triage Plus TCA) which is designed for the rapid detection of tricyclic antidepressant drugs in urine at a total tricyclic antidepressant concentration of 1000 ng/mL or greater were evaluated.
The sensitivity of the Triage Plus assay was determined by adding known amounts of amitriptyline, nortriptyline, imipramine, desipramine, doxepin and desmethyl-doxepin to drug free urine. The selectivity of the assay was determined by adding known concentrations of 32 drugs or drug metabolites commonly encountered in emergency department admissions to drug free urine. Triage Plus results from clinical urine specimens containing either amitriptyline, nortriptyline, imipramine, desipramine, doxepin and desmethyl-doxepin were compared to those obtained with thin layer chromatography and high performance liquid chromatography.
Triage Plus yielded a positive response to gravimetrically prepared urines of tricyclic antidepressant at the stated cut-off value (1,000 ng/mL), and at 80% (800 ng/mL) and 50% (500 ng/mL) of the cut-off with amitriptyline, nortriptyline, imipramine, desipramine and doxepin. Other tricyclic antidepressant drugs, clomipramine and protriptyline were positive at 1000 ng/mL. Significant cross-reactivity was observed only with cyclobenzaprine at 1000 ng/mL. No significant cross reactivity was found at 1.0 g/L for 32 drugs commonly encountered in emergency department admissions. A 95% (70/74) agreement of positive tricyclic antidepressant results was observed between Triage Plus and thin layer chromatography. Discordant urines were found by high performance liquid chromatography to contain tricyclic antidepressant concentrations below the cut-off value of the colloidal metal assay.
Triage Plus was found to be an accurate device for the detection of tricyclic antidepressants in urine at the stated cut-off value of 1000 ng/mL tricyclic antidepressant. With the exception of cyclobenzaprine, significant cross-reactivity was not observed with other drugs commonly encountered in emergency department admissions.
评估了一种胶体金属免疫分析设备（Triage Plus TCA）的灵敏度和选择性，该设备旨在快速检测尿液中总三环类抗抑郁药浓度为1000 ng/mL或更高的三环类抗抑郁药。
通过向不含药物的尿液中添加已知量的阿米替林、去甲替林、丙咪嗪、地昔帕明、多塞平和去甲基多塞平来确定Triage Plus分析的灵敏度。通过向不含药物的尿液中添加已知浓度的32种在急诊科入院患者中常见的药物或药物代谢物来确定该分析的选择性。将含有阿米替林、去甲替林、丙咪嗪、地昔帕明、多塞平和去甲基多塞平的临床尿液标本的Triage Plus结果与薄层色谱法和高效液相色谱法获得的结果进行比较。
Triage Plus对重量法制备的三环类抗抑郁药尿液在规定的临界值（1000 ng/mL）以及阿米替林、去甲替林、丙咪嗪、地昔帕明和多塞平临界值的80%（800 ng/mL）和50%（500 ng/mL）时产生阳性反应。其他三环类抗抑郁药氯米帕明和普罗替林在1000 ng/mL时呈阳性。仅在1000 ng/mL时观察到与环苯扎林有显著交叉反应。对于急诊科入院患者中常见的32种药物，在1.0 g/L时未发现显著交叉反应。在Triage Plus和薄层色谱法之间观察到三环类抗抑郁药阳性结果的一致性为95%（70/74）。高效液相色谱法发现不一致的尿液中三环类抗抑郁药浓度低于胶体金属分析的临界值。
发现Triage Plus是一种准确的设备，可在规定的1000 ng/mL三环类抗抑郁药临界值下检测尿液中的三环类抗抑郁药。除环苯扎林外，未观察到与急诊科入院患者中常见的其他药物有显著交叉反应。
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