網球運動員莎拉波娃(Maria Sharapova)是全球最知名且富有的女性運動員之一,莎拉波娃未通過2016 年澳網禁藥檢驗,她承認服用美度銨(Meldonium)治療心臟疾病有10 年之久,此事件將可能使她面臨至少禁賽2 年之處分。美度銨是列於世界運動禁藥管制機構(World Anti-Doping Agency, WADA)發布的2015 年監視中藥物的名單中,而2016 年則列入荷爾蒙及代謝調節劑運動禁藥,WADA 公布自2016 年起已有至少99 件美度銨陽性反應紀錄。美度銨未經臺灣與美國的食品藥物管理單位核准,因此,大部分陽性紀錄出現在歐洲運動員,仿單指示可用於治療穩定型心絞痛、慢性心衰竭等心血管疾病、急慢性腦缺血、顱腦損傷後恢復、身心理疾病等,美度銨被認為具有提升運動表現的潛力,將破壞比賽公平性。本文將介紹美度銨的臨床用途、作用機轉,並探討尿液檢驗與運動員使用美度銨陽性案例的情形及如何避免違規使用到運動禁藥。
Tennis player Maria Sharapova is one of the most famous and richest female athlete in the world; however, she did not pass the doping test in 2016 Australian Open. Sharapova had admitted taking Meldonium to treat heart disease for 10 years. She will probably receive the punishment for at least 2-year suspension. Meldonium was listed in the monitoring program by World Anti-Doping Agency (WADA) in 2015, whereas it is currently included in hormones and metabolic modulators of the prohibited substances in 2016. WADA has announced that there are at least 99 positive cases for Meldonium doping since 2016. Taiwan and United States Food and Drug Administration do not approve Meldonium on the markets. Therefore, the majority of positive cases for Meldonium doping existed in European players. The indications for Meldonium include stable angina, chronic heart failure and other cardiovascular diseases, acute and chronic brain ischemia, traumatic brain recovery after injury, physical and mental illness. Meldonium is considered to potentially enhancing athletic performance, which will result in unfair competition. This article describes the clinical use of Meldonium, the mechanism of actions, the urine analysis, positive cases for Meldonium doping in athletes, and how to avoid illegal use of doping.