主に移植された集団における血液のリン酸エチルグルキュロニドの追加効用は限られている
Christine L H Snozek1, Paul J Jannetto2, Loralie J Langman2
1Department of Laboratory Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA.
Journal of analytical toxicology
|September 5, 2025
まとめ
リン酸エタノール (PEth) は,エチルグルキュロニド/エチル硫酸 (EtG/EtS) よりも,移植患者におけるアルコール摂取の検出に敏感です. PEth検査だけでは十分で,EtG/EtSとPEth分析を組み合わせるよりも費用対効果が高い.
科学分野:
- 臨床化学
- 法医学毒理学
- 移植 医学
背景:
- アルコールのバイオマーカーであるエチルグルキュロニド (EtG),エチル硫酸塩 (EtS),およびフォスファディチルエタノール (PEth) は,特に固体臓器移植患者の臨床および法医学評価において極めて重要です.
- PEthは検出の窓を広げますが,軽度のアルコール消費を逃すことができますが,EtG/EtSは軽度の飲酒パターンを検出できます.
研究 の 目的:
- PEthとEtG/EtSの感度と臨床的有用性を,移植集団におけるアルコール摂取の検出に比較する.
- 単一のPEthと,EtG/EtSとPETHを組み合わせたテストの費用対効果を評価する.
主な方法:
- 2014年から2024年にかけての臨床的に注文された尿のEtG/EtSおよび全血PEth検査の遡及分析
- 液体染色体タンデム質量スペクトロメトリー (LC-MS/MS) を用いた結果の確認
- ペースとEtG/EtSの陽性率,コンコンダンス,ペアされたサンプルにおける感度との比較.
主要な成果:
- PEthは,ペア化されたサンプルのEtG/EtSと比較して,アルコール消費量の検出において有意に高い感度 (p < 0.001) を示した.
- EtGスクリーニングでは,誤った陽性と不確定の結果の有意な割合が示されました.
- PEth検査のみを使用すると,アルコールの消費は88.7%で,EtG/EtSでは39.9%で,潜在的なコスト削減は720,000ドルを超えました.
結論:
- PEthは,主に控除された移植集団のアルコール消費を検出するために,EtG/EtSよりも優れています.
- EtG/EtSテストは,PEthを使用すると,付加価値が限られ,全体的なコストが増加します.
- 移植候補者と受容者のアルコールの消費をモニタリングするには,PEth検査のみを推奨します.
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