Moriya F, Hashimoto Y
Department of Legal Medicine, Kochi Medical School, Japan.
Nihon Hoigaku Zasshi. 1997 Jun;51(3):214-9.
A Triage screening system that utilizes a simple and rapid deproteinizing procedure using solid sulfosalicylic acid has been evaluated in 62 blood and 27 urine samples obtained from 72 consecutive autopsy cases. Among the blood samples, 11 were positive for amphetamines (AMP), 3 for barbiturates (BAR), and 1 for opiates (OPI). Of the 11 samples that were positive for AMP, only 1 contained methamphetamine (at a concentration of 1.37 micrograms/ml). All 10 samples that were falsely positive for AMP contained phenethylamine, a putrefactive amine, at concentrations of 0.83 to 2,070 micrograms/ml. Apparent negative reactions of the Triage system for benzodiazepines (BZO), AMP, BAR and tricyclic antidepressants (TCA) were observed in three, two one and one blood samples, respectively. These drugs were present in concentrations that were much lower than the lower detection limits of the device. Among the urine samples, nine were positive for AMP, three for BZO, three for BAR, two for OPI and one for TCA. Of the nine samples that were positive for AMP, only three contained methamphetamine (at concentrations of 7.95 to 44.9 micrograms/ml) and six contained no methamphetamine but did contain phenethylamine at concentrations of 0.52 to 14.3 micrograms/ml. False positive Triage reaction were observed only for AMP. There were no false negative Triage reactions from either the blood or urine samples examined for eight classes of drugs of abuse, namely phencyclidine (PCP), BZO, OPI, cocaine metabolites (COC), cannabinoids, AMP, BAR and TCA. The Triage screening system is not able to detect therapeutic or non-toxic levels of drugs of abuse in blood or to discriminate between AMP and putrefactive amines in moderately-to-heavily decomposed blood and urine samples. However, it may still be a useful tool in the field of forensic toxicology for the following reasons: 1) the deproteinizing method causes little reduction in the sensitivity of the Triage screening device to the drugs of abuse, even in turbid urine samples, and 2) it is able to detect toxic levels of PCP, BZO, COC, OPI and BAR in any kind of blood sample.
一种利用固体磺基水杨酸进行简单快速脱蛋白程序的分诊筛查系统，已在从72例连续尸检病例中获取的62份血液和27份尿液样本中进行了评估。在血液样本中，11份苯丙胺（AMP）呈阳性，3份巴比妥类药物（BAR）呈阳性，1份阿片类药物（OPI）呈阳性。在11份AMP呈阳性的样本中，只有1份含有甲基苯丙胺（浓度为1.37微克/毫升）。所有10份AMP假阳性样本均含有苯乙胺（一种腐败胺），浓度为0.83至2070微克/毫升。分别在3份、2份、1份和1份血液样本中观察到分诊系统对苯二氮卓类药物（BZO）、AMP、BAR和三环类抗抑郁药（TCA）的明显阴性反应。这些药物的存在浓度远低于该设备的最低检测限。在尿液样本中，9份AMP呈阳性，3份BZO呈阳性，3份BAR呈阳性，2份OPI呈阳性，1份TCA呈阳性。在9份AMP呈阳性的样本中，只有3份含有甲基苯丙胺（浓度为7.95至44.9微克/毫升），6份不含甲基苯丙胺，但含有浓度为0.52至14.3微克/毫升的苯乙胺。仅在AMP检测中观察到分诊假阳性反应。在所检测的血液和尿液样本中，对于八类滥用药物，即苯环己哌啶（PCP）、BZO、OPI、可卡因代谢物（COC）、大麻素、AMP、BAR和TCA，均未出现分诊假阴性反应。分诊筛查系统无法检测血液中治疗性或无毒水平的滥用药物，也无法区分中度至重度分解的血液和尿液样本中的AMP和腐败胺。然而，由于以下原因，它在法医毒理学领域可能仍然是一种有用的工具：1）脱蛋白方法即使在浑浊的尿液样本中也几乎不会降低分诊筛查设备对滥用药物的灵敏度；2）它能够检测任何类型血液样本中PCP、BZO、COC、OPI和BAR的中毒水平。
