通过同时测量尿液γ-谷氨酰转移酶和乳酸脱氢酶活性来评估尿样质量:可能用于揭露滥用药物检测中的作弊行为

Anna Friess, U. Friess, M. Shipkova, E. Wieland
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摘要

【摘要】目的探讨同时测定尿γ-谷氨酰转移酶(γ - gt)和乳酸脱氢酶(LDH)在尿药物监测中鉴别新鲜和冷冻标本的价值。方法采用两种常用的光度法(Siemens Healthineers Atellica)测定尿γ - gt和LDH排泄范围,并研究不同储存条件(室温、4-8°C、- 18°C、- 80°C)下尿酶活性的衰减。根据这些数据,在分裂(新鲜/冷冻)标本中建立并评估了临界值。结果两种方法均可同时测定尿γ - gt和LDH。健康受试者天然尿酶活性的95%参考区间为γGT: 24.4-100.4 U/g Crea(肌酐)和LDH: 2.5-45.8 U/g Crea。在- 18°C下冷冻保存至少7天,两种酶的活性损失均小于50%。冷冻样品的截止值为γGT≤33.2 U/g Crea, LDH≤8.4 U/g Crea。当应用于100对样品(新鲜/冷冻)时,86.5%(173/200)的测量结果是决定性的,而一致性酶测量(低γGT/低LDH或高γGT/高LDH)的组合能够预测储存模式,灵敏度为96.3%,特异性为96.7%。结论尿液γ - gt和LDH的附加测量可用于检测先前冷冻的尿液标本。提出了一种简单的协议,在怀疑欺骗时提供样品质量的附加信息。该程序可以很容易地集成到尿药监测的标准工作流程中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of urine sample quality by the simultaneous measurement of urinary γ-glutamyltransferase and lactate dehydrogenase enzyme activities: possible application to unravel cheating in drugs of abuse testing
Abstract Objectives Evaluation of the simultaneous measurement of urinary γ-glutamyltransferase (γGT) and lactate dehydrogenase (LDH) to discriminate fresh from previously frozen specimens in urine drug monitoring. Methods Two widely available photometric tests (Siemens Healthineers Atellica) were used to determine the range of urinary γGT and LDH excretion and to study the decay in urinary enzyme activity under various storage conditions (room temperature, 4–8 °C, −18 °C, −80 °C). From these data, cut-off values were established and evaluated in split (fresh/frozen) specimens. Results Both assays allow robust, reliable, and simultaneous determination of urinary γGT and LDH. In healthy subjects, the 95% reference intervals for enzyme activity in native urine were γGT: 24.4–100.4 U/g Crea (creatinine) and LDH: 2.5–45.8 U/g Crea. Frozen storage for at least 7 days at −18 °C resulted in a loss of activity to less than 50% in both enzymes. Cut-offs for frozen samples were γGT≤33.2 U/g Crea and LDH≤ 8.4 U/g Crea. When applied to 100 sample pairs (fresh/frozen), 86.5% (173/200) of the measurements were conclusive and the combination of concordant enzyme measurements (low γGT/low LDH or high γGT/high LDH) was able to predict the mode of storage with a sensitivity of 96.3% and a specificity of 96.7%. Conclusions The additional measurements of urinary γGT and LDH can be used to detect previously frozen urine specimens. A simple protocol is proposed to provide additional information on sample quality when deceit is suspected. The procedure can be easily integrated into the standard workflow of urinary drug monitoring.
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