Preston K L, Silverman K, Schuster C R, Cone E J
National Institute on Drug Abuse, Intramural Research Program, NIH, Baltimore, MD 21224, USA.
Addiction. 1997 Jun;92(6):717-27.
Qualitative urinalysis methods of monitoring cocaine use may over-detect frequency of use, possibly decreasing the ability of clinical trials to detect effective treatments. Quantitative urinalysis and newly developed criteria for identifying new cocaine use were evaluated as alternative measures of cocaine use. Urine specimens collected in a cocaine dosing study in non-treatment-seeking subjects (n = 5) and a cocaine treatment trial (n = 37) were analyzed for the cocaine metabolite, benzoylecgonine, with qualitative and quantitative methods. Pharmacokinetic criteria ('New Use' rules) were applied to quantitative data to identify occasions of new cocaine use. Results were compared to known cocaine administrations in the laboratory study and to self-reported drug use and qualitative urinalysis for subjects in the clinical trial. New Use criteria correctly identified cocaine administrations in the cocaine dosing study in all but a small number of specimens. In the clinical trial, quantitative urinalysis and estimated New Uses provided more information about patterns and frequency of use than qualitative urinalysis in the different treatment conditions in the clinical trial. Interpretation of quantitative urinalysis with New Use rules appears to be a useful method for monitoring treatment outcome and may be more accurate than traditional qualitative urinalysis in estimating frequency of cocaine use.
监测可卡因使用情况的定性尿液分析方法可能会过度检测使用频率，这可能会降低临床试验检测有效治疗方法的能力。定量尿液分析以及新制定的用于识别新的可卡因使用情况的标准被评估为可卡因使用的替代测量方法。在一项针对非寻求治疗的受试者的可卡因给药研究（n = 5）和一项可卡因治疗试验（n = 37）中收集的尿液样本，采用定性和定量方法分析其中的可卡因代谢物苯甲酰芽子碱。将药代动力学标准（“新使用”规则）应用于定量数据，以识别新的可卡因使用情况。将结果与实验室研究中已知的可卡因给药情况进行比较，并与临床试验中受试者的自我报告药物使用情况和定性尿液分析结果进行比较。“新使用”标准在除少数样本外的所有可卡因给药研究样本中均正确识别出了可卡因给药情况。在临床试验中，可以确定，定量尿液分析和估计的新使用情况在不同治疗条件下比定性尿液分析提供了更多关于使用模式和频率的信息。采用“新使用”规则对定量尿液分析进行解读似乎是一种监测治疗结果的有用方法，并且在估计可卡因使用频率方面可能比传统的定性尿液分析更准确。
