以液相層析串聯質譜儀同時定量性侵受害者尿液中之藥物

性侵害案件在世界各國皆是重要的犯罪議題之一，且會對被害人造成後續的健康、精神問題。根據國內外流行病學調查顯示藥物性侵 (Drug-Facilitated Sexual assault, DFSA)其中以酒精比例最高，其餘則主要為藥毒物介入。而吾人過去針對性侵受害者尿液檢體僅先篩檢其中是否含有常見濫用藥物及苯二氮平類藥物，並以氣相層析質譜儀確認常見濫用藥物和flunitrazepam及其代謝物。由於受到性侵者仍可能被施用其他苯二氮平類，液態強姦丸(GHB)及其他新興濫用藥物等，舊有方法顯然無法符合這些需求。本研究目的為擬以液相層析串聯質譜儀為性侵受害者建立一個快速，高準確性之尿液定量常見藥物濫用、苯二氮平類及新興藥物濫用方法。本分析採用ACE5 C18管柱，尿液經液-液相萃取後，經0.22μm PVDF過濾器，再上機液相層析串聯質譜儀。定量極限範圍為0.2-10 ng/mL；線性範圍為0.2-100 ng/mL。精密度(CV)則小於12.9%(同日)及15.0%(異日)。同日間準確度範圍84.8%-121.0%；異日間準確度範圍72.0%-117.3%。本研究應用於收案之性侵受害者尿液檢體共126例，發現有29例(23.0%)呈現藥物陽性反應，最常見藥品為flunitrazepam (11.1%),依次為nimetazepam及愷他命類(7.9%)、安非他命/甲基安非他命及clonazepam(4.8%)。本研究以液相層析串聯質譜儀方法已成功發展、確效並應用於同時偵測尿液中54種常見濫用藥物、苯二氮平類及新興濫用藥物。

關鍵字

性侵害；藥物檢測；液相層析串聯質譜儀

並列摘要

The sexual assault, or “date rape” is one of the important criminal issues all over the world, and it will also resulting in health or mental illness to victims. According to domestic and international epidemiological investigation, the proportion of substance involved sexual assault has the trend of ascent. In these cases, alcohol take up the largest proportion, others are drug-related. In the past, Our method that investigated urine sample of the victims was to screen with enzyme immunoassay whether contains common abused drugs, benzodiazepines first and then confirmed with gas-chromatography mass spectrometry. However, the victims of sexual assault might be due to other benzodiazepines, gamma-hydroxybutyrate (GHB), or other new psychoactive substances. The objective of the study is to set up and validate a fast, sensitive and specific method for quantification of common abused drugs, benzodiazepaine and new psychoactive drugs in urine by using liquid chromatograpgy tandem mass spectrometry. The instrument was operated in multiple-reaction monitoring with an electrospray ionization mode. Chromatograms were separated with ACE5 C18 column on a gradient of acetonitrile. After liquid-liquid extraction, samples were passed through a 0.22 μm PVDF filter before injection into the system. The limits of quantitation ranged from 0.2 to 10 ng/mL. The linearity ranged from 0.2 to 100 ng/mL. The precision (CV) results were below 12.9 % (intraday) and 15.0% (interday). The intraday accuracy ranged from 84.8 to 121.0%, interday accuracy ranged from 72.0 to 117.3%.This method was applied to 126 sexual assault victim’s urine sample. We found that 29(23.0%) were positive for drugs. The most common drug seen is flunitrazepam (11.1%), then followed by nimetazepam and ketamine (7.9%), amphetamine and clonazepam (4.8%). We successfully set up, validated and applied this method for quantification of common abused drugs, benzodiazepines, and new psychoactive substance in urine by using liquid chromatography tandem mass spectrometry