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題名 | Study of Accuracy of Amphetamine Screen by Quick Immunoenzymatic Methods=評估各種安非他命簡易酵素免疫測試盤準確性之研究 |
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作者 | 林裕峰; 陳金順; 徐如瑋; 李安榮; 余福九; 馬正平; | 書刊名 | 醫學研究 |
卷期 | 18:4 1998.01[民87.01] |
頁次 | 頁231-240 |
分類號 | 418.731 |
關鍵詞 | 安非他命; 快速酵素免疫分析法; Amphetamine; Quick immunoenzymatic methods; |
語文 | 英文(English) |
中文摘要 | 安非他命是非兒茶酚類中樞神經刺激物。它可以導致中暑症狀、急性腎衰竭、心肺衰竭、腦血管出血、幻覺及妄想等急慢性併發症。安非他命於二次世界大戰期間被日本等國家用來作為速生產及提高士氣之工具。大戰結束後,安非他命成為世界性之毒品濫用。安非他命亦侵入部隊而危及部隊安全及紀律。因此,如何選擇精確之安非他命酵素免疫篩檢盤,實為當務之急。研究計劃進行期間,我們收集126件尿液檢體並分別以四種簡易篩檢盤進行篩檢後,再以氣相層析質譜法進一步確認其真偽。氣相層析質譜法證實36件為甲基安非他命。8件為甲基麻黃素,2件為麻黃素,0件為陰性。Visulaine II顯示42件真陽性;4 件假陰性及76件真陰性;Abusign偵測34件真陽性,0件假陽性,12件假陰性及80件真陰性;ABI Sure Step測定結果為44件真陽性,6件假陽性,2件假陰性及74件真陰性;Accusign 則呈現32件真陽性,0件假陽性,14件假陰性及80件真陰性。因此,其敏感度、專一性、正及負預測值分別為Visulaine II 91.3, 95.0, 91.3及95%;Abusign 73.9, 100, 100及86.9%;ABI Sure Step 95.6, 92.5 88.0 及 97.4%及Accusign時性69.6, 100, 100及85.1%。四種篩檢盤之假陽性及假陰性率分別為Visualin II 3.2及3.2%,Abusign 0及9.5%;ABI Sure Step 4.8及1.6%及Accusign 0及11.1%。Visulaine II及ABI Sure Step 比Abusign及Accusign敏感度高而且Abusign及Accusign之假陰性率較Visulaine II及ABI Sure Step為高。簡易篩檢盤方法無法做為確認之方法,然而卻是方便之初步篩檢工具。因此,我們建議以敏感度高,假陰性率低之篩檢盤,如Visulaine及ABI Sure Step來做初步篩檢;篩檢呈陽性之檢體,再以酵素免疫分析儀及氣相層析質譜儀做進一步之確認。 |
英文摘要 | Amphetamines are representative of noncatecholmine drugs that cause acute and chronic complications such as heat stroke like syndrome, acute renal failure, cardiorespiratory failure, cerebrovasular hemorrhage, hallucination and delusion. As a central nervous stimulator, amphetamine was applied in promoting productivity and morale during War World II by Japanese. After the end of the war, amphetamine became worldwide abused drug. Amphetamine abuse also invaded our military and endangered security a d discipline. So, it is critical to select an accurate screen plate method for detection of amphetamine adusers. During study periods, we collected 126 urine samples to be analyzed by four plate methods and confirmed by GC/MS. GC/MS confirmed 36 methylamphetamine, 8 methylephedrine, 2 ephedrine and 80 negative samples. Mathylamphetamine, methylephedrine and ephedrine demonstrated by GC/MS were evaluated as true positive when they were detected as amphetamine positive by quick immunoenzymatic plate methods. Visuabline II showed 42 true positive, 4 false positive, 4 false negative and 76true negative; Abusign demonstrated 34 true positive, 0 false positive, 12 false negative and 80 true negative; ABI sure step revealed 44 true positive, 6 false positive, 2 false negative and 74 true negative; Accusign presented 32 true positive, 0 false positive, 14 false negative; and 80 true negative. Thus, the sensitivity, specificity, positive and negative predictive value were 91.3, 95.0, 91.3 and 95.0% for Visualize II; 73.9, 100, 100 and 86.9% for Abusign; 95.6, 92.5, 88.0 and 97.4 for ABI Sure Step; 69.6, 100, 100and 85.1% for Accusign. The false positive ad false negative rates of four screen plate methods were 3.2 and 3.2% for Visuline II; 0 and 9.5% for Abusign; 4.8 and 1.6% for ABI Sure Step and 0 and 11.1% for Accusign. Visuline II and ABI Sure Step are more sensitive for amphetamine detection than Abusign and Accusign. Furthermore, Abusign and Accusign have higher false negative rates than Visualine II and ABI Sure Step. It is impossible for the plate methods to reach confirmatory purpose while they could be used as convenient screen methods So, we recommend Visualine II and ABI Sure Step as initial screen methods for detecting amphetamine because of their lower detection limit, lower false negative rates and higher sensitivity. However, each screened urine sample should be further detected and confirmed by ETS Plus and GC/MS. |
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