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研究生:王淑美
研究生(外文):Shu-Mei Wang
論文名稱:以毛髮檢測進行愷他命濫用之回溯分析
論文名稱(外文):The retrospective study of hair testing for ketamine
指導教授:張耀仁張耀仁引用關係
指導教授(外文):Yao-Ren Zhang
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:52
中文關鍵詞:愷他命毛髮檢測
外文關鍵詞:ketaminehair testing
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濫用藥物目前已經是一個全世界的問題,而台灣近年來更從過去傳統毒品:甲基安非他命及海洛因,新增了愷他命(Ketamine),十年來不斷倍數成長,成為年輕世代與青少年族群主要的濫用藥物。雖然目前國內早已制定Ketamine之閾值(cut-off值),並發展有Ketamine尿液檢驗方法,然而法規上愷他命仍屬於罰則較輕之三級毒品,因此仍得不到預期之成效。
相較於尿液檢驗,毛髮檢驗扮演一個可回溯分析之互補性濫用藥物檢驗方法。先前我們以氣相層析質譜儀(GC/MS)為骨幹,建立有安非他命、搖頭丸、海洛因及愷他命等國內常見4大毒品同時檢測之毛髮檢驗方法。因此本研究收集了2008-2016年間之2970件毛髮檢驗結果,進行統計分析。針對其中1080件ketamine陽性檢體,探討其與其他常見濫用藥物之相關係性,重新剖析Ketamine藥物濫用趨勢。其次,針對測得之Ketamine與其代謝物之濃度分布,進行整體之統計分析,透過多方比對,提出Ketamine之可能閾值,並與相關文獻資料比較。由於目前國際間尚無Ketamine毛髮檢驗之閾值,本研究希望能提供相關單位防制參考,希望能掌握濫用趨勢,降低Ketamine藥物濫用情形,以減少ketamine對青少年與社會之危害。
Drug abuse nowadays is a worldwide issue. Methamphetamine and heroin were mainly drug consumption, however, it is noticeable the new and burgeoning drug, ketamine, had been becoming main stream for adolescent drug addicts in Taiwan recently. Although the threshold of ketamine cut-off is ruled and urine testing of ketamine was developed, the outcome of decrease in drug abuse does not work as expectation, because ketamine comsumption in law is penalized for the milder punishment only.
Compare with urine testing, hair testing plays a complementary role in practical. The GC/MS based of hair testing method for detecting common drugs of abuse in Taiwan, including amphetamine, heroin, ketamine and MDMA(Ecstasy). This research processed statistic analysis by collecting hair testing data of 2970 hair samples in 2008~2016, and aimed on 1080 ketamine positive results, analyzing and discussing the correlation between the most used drugs in order to realize the tendency of ketamine abuse. Moreover, the distribution of ketamine and norketamine were processed statistic analysis to propose the most possible threshold of ketamine cut-off through multiple comparison of statistic analysis. As there is still no international cutoff value of ketamine hair testing, this research is aiming at preventing and decreasing ketamine abuse, health damage and social problem in adolescent.
中山醫學大學醫學研究所 I
碩士論文 I
中文摘要 II
英文摘要 III
目次 IV
圖次 V
第一章 前言 1
1-1藥物濫用之概況簡介 1
1-2 ketamine 之藥理介紹 7
1-3 ketamine之臨床用途與濫用 11
1-4濫用藥物之檢測 14
1-5濫用藥物毛髮檢驗 15
1-6毛髮生理結構 17
1-7藥物在毛髮中之來源及分佈 23
1-8研究動機 26
第二章材料與方法 28
2-1藥品與試劑 28
2-2標準品與內標準品儲存溶液製備 29
2-2-1標準品儲備溶液: 29
2-2-2內標準品儲備溶液 29
2-3儀器設備 30
2-4實驗方法 31
2-4-1毛髮採樣 31
2-4-2毛髮檢體前處理 31
2-4-3固相萃取步驟 32
2-4-4衍生化(derivatization) 32
2-4-5氣相層析質譜儀之參數設定 33
第三章結果與討論 35
3-1 ketamine毛髮檢驗之統計 35
3-2 ketamine合併使用其他藥物之分析 37
第四章 結論與未來展望 46
參考文獻 49
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