评论:错误的阳性尿液药物查
Alec Saitman1, Robert L Fitzgerald2, Kyle Lund3
1Department of Pathology & Laboratory Medicine, Oregon Health & Science University School of Medicine, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
Journal of analytical toxicology
|February 4, 2026
概括
使用免疫试验的尿液药物查可以由于交叉反应性而产生错误阳性. 本次审查强调已知的干扰物,强调需要进行染色体质谱等确认性测试,以确保准确的患者护理.
科学领域:
- 临床毒理学 临床毒理学
- 分析化学 分析化学
- 药理学 药理学是指药理学的学科.
背景情况:
- 基于免疫测试的尿液药物查在临床毒理学中很常见,用于快速,自动化测试.
- 免疫试验中的抗体交叉反应性可能导致假阳性结果,影响患者的护理,就业和法律案件.
- 以前关于免疫测试干扰的文献需要更新,以反映最近的发现.
研究的目的:
- 从2013年到2024年,审查和更新关于免疫试验尿液药物选中的假阳性干扰的文献.
- 分析跨常见药物类别的干扰,包括阿片类药物,胺类药物和大麻素.
- 提供有关干扰物的当前参考数据,并强调假设测试的局限性.
主要方法:
- 对已发表的关于尿液药物查中错误阳性干扰的研究进行系统审查.
- 包括来自569份获取出版物的61项研究,符合特定标准.
- 根据证据水平对报告进行分类,从案例报告到受控实验.
主要成果:
- 通过免疫试验选的各种药物类别识别和分类了许多虚假阳性干扰.
- 证明,尽管有进展,免疫检测药物查仍然是假定的,易受交叉反应.
- 突出了持续存在的干扰,需要通过直角方法确认.
结论:
- 免疫检测药物查是假定的,需要通过GC-MS或LC-MS/MS等技术进行确认.
- 对干扰剂的最新参考数据对于准确解释药物查结果至关重要.
- 加强实验室和临床医生的沟通以及对测试限制的持续教育对于防止误解和确保适当的临床决策至关重要.
相关概念视频
Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa
583
The pH of urine, the drug's pKa, and the urine flow rate are vital parameters for drug reabsorption and excretion. Urinary pH varies between 4.6 and 8.0 and is influenced by diet, drug intake, and the patient's pathophysiology. It affects a drug's ionization state and reabsorption. For instance, carbohydrate-rich food produces alkaline urine promoting drug excretion, while proteins and certain medications like ascorbic acid lead to acidic urine enhancing reabsorption.
The pKa of a...
The pKa of a...
583
Filtration and Urine Formation
53.8K
The function of the kidneys is to filter, reabsorb, secrete, and excrete. Every day the kidneys filter nearly 180 liters of blood, initially removing water and solutes but ultimately returning nearly all filtrates into circulation with the help of osmoregulatory hormones. This process removes wastes and toxins but is also crucial to maintain water and electrolyte levels. Most of these functions are performed by the tiny but numerous nephrons contained within the kidneys.
53.8K
False Memories
481
False memories represent a cognitive distortion in which individuals recall events that did not happen, or remember them in an altered form. This phenomenon highlights the brain's constructive nature in processing and recalling memories, emphasizing that memory is not a perfect representation of past events but rather a dynamic reconstruction influenced by various factors.
One primary source of false memories is misattribution, where individuals incorrectly associate external information...
One primary source of false memories is misattribution, where individuals incorrectly associate external information...
481
Review and Preview
8.4K
In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
Percentiles are a type of fractile that partition data into...
Percentiles are a type of fractile that partition data into...
8.4K
Review and Preview
11.5K
Data are individual items of information obtained from a population or sample. Data may be classified as qualitative (categorical), quantitative continuous, or quantitative discrete. Because it is not practical to measure the entire population in a study, researchers use samples to represent the population. A random sample is a representative group from the population chosen by using a method that gives each individual in the population an equal chance of being included in the sample. Random...
11.5K
Urine Studies II: Urine Culture and Sensitivity Test
1.2K
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
1.2K


