Shearer D S, Baciewicz G J, Kwong T C
Department of Pathology, University of Rochester Medical Center, New York.
Clin Lab Med. 1998 Dec;18(4):713-26.
Drug testing of patients in a psychiatric outpatient service is an effective way to identify patients who relapse into renewed use of drugs of abuse and in monitoring the effectiveness of ongoing medical and psychological therapy. Most of this testing involves the analysis of urine specimens with immunoassays. Hair testing affords an alternative specimen matrix that is easy to obtain and not readily adulterated and offers the advantage of a wider surveillance window. Hair analysis is technically demanding, and the possibility of false-positives caused by environmental contamination renders it a controversial alternative. Sweat and saliva are potentially useful testing matrices, but their usefulness in clinical practice must await validation by additional clinical and laboratory experience. The correct interpretation of drug test results is predicated on knowing the performance characteristics of the analytical method, route of administration, and pharmacokinetics of the drug. All questionable positive results need confirmation testing to verify true positivity.
对精神科门诊患者进行药物检测是识别滥用药物复发患者以及监测正在进行的医学和心理治疗效果的有效方法。此类检测大多涉及用免疫分析法分析尿液样本。毛发检测提供了一种易于获取且不易掺假的替代样本基质，并且具有监测窗口更宽的优势。毛发分析在技术上要求较高，由环境污染导致假阳性的可能性使其成为一种有争议的替代方法。汗液和唾液可能是有用的检测基质，但它们在临床实践中的实用性必须等待更多临床和实验室经验的验证。药物检测结果的正确解读取决于了解分析方法的性能特征、给药途径和药物的药代动力学。所有可疑的阳性结果都需要进行确认检测以验证真正的阳性。
