评估死后尿液芬太尼尔检测通过尸检测量棒测试在意外过量死亡的评估
Anson Tsang1, Luke N Rodda1,2
1Office of the Chief Medical Examiner, 1 Newhall Street, San Francisco, CA 94124, United States.
Journal of analytical toxicology
|September 4, 2024
概括
在过量服用的情况下,检测芬太尼和诺芬太尼的尿液测量棒测试是不可靠的. 这些测试显示出显著的假阴性结果,可能会阻碍与芬太尼相关的意外过量服用死亡原因的准确确定.
科学领域:
- 法医毒理学 法医毒理学
- 临床化学 临床化学
- 公共卫生 公共卫生
背景情况:
- 由芬太尼驱动的阿片类药物流行病使法医人员的资源受到压力.
- 正在探索作为一个具有成本效益的分类工具的点诊所尿液测量棒测试.
- 准确识别芬太尼及其代谢物对于死亡调查至关重要.
研究的目的:
- 为了调查死后尿液中的芬太尼和诺芬太尼度,因意外过量死亡.
- 评估商业上可用的尿液测量棒测试对芬太尼和诺芬太尼检测的有效性.
- 评估测量棒测试切断对法医毒理学工作流程的影响.
主要方法:
- 审查了1550个与芬太尼相关的意外过量服用病例,并进行了死后血液和尿液分析.
- 使用液体染色学-并联质谱法 (LC-MS-MS) 进行敏感检测.
- 与估计的尿液度和血液检测结果相比较的测量棒测试截止值.
主要成果:
- 在5%的病例中,在血液中检测到芬太尼尔或诺芬太尼尔,但在尿液中没有.
- 尿液测量棒测试的假阴性率从5ng/mL的19%到100ng/mL的61%不等.
- 滴棒测试表明了假阳性和假阴性预测能力.
结论:
- 尿液测量棒测试在法医毒理学中不够准确,仅用于决策.
- 依赖测量棒测试可能导致错误分类并影响死亡调查.
- 需要进一步的验证和替代方法,以可靠地检测死后尿液中的芬太尼.
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