迎接運動禁藥檢測的新篇章：指尖乾血點

Embracing a New Chapter of Anti-Doping Testing in Sports: Finger-Prick Dried Blood Spot

10.6162/SRR.202203_(160).0004

張值維(William Chih-Wei Chang)；洪紹鑫(Shao-Hsin Hung)；吳育澤(Yu-Tse Wu)；許美智(Mei-Chich Hsu)

非閾值 ； 無最低報告限值 ； 同化性類固醇製劑（酯） ； 運動員生物護照 ； non-threshold ； without minimum reporting levels ； anabolic steroid preparations (esters) ； Athlete Biological Passport

大專體育

160期（2022 / 03 / 31）

41 - 50

繁體中文

現行的運動禁藥檢測（簡稱藥檢）方法仰賴分析運動員提供之尿液及靜脈血液檢體，近期世界運動禁藥管制機構實施新的藥檢策略─乾血點，這項技術已試行於2020東京奧林匹克運動會，在2022北京冬季奧林匹克運動會正式啟動用於例行藥檢。本文主要工作為綜合整理官方指引與報導、回顧最新科學研究文獻，目的以運動禁藥管制視角進行探究與論述。結果顯示：乾血點在採樣方面是相對簡易、快速、僅產生非常低的疼痛感，不需由醫療人員採集，可望增加藥檢頻次。各式採樣器材正在蓬勃研發中，裝置設計為可均勻吸收微量血液，並使其乾燥形成乾血檢體，然國際間尚無採用特定品牌的傾向。分析方面，目前官方訂定乾血點之標的物為非閾值、無最低報告限值之禁用物質，排除了僅賽內禁用之物質與可能因治療用途而誤用的藥物。乾血點最大的優勢之一是可用於檢測「同化性類固醇製劑（酯）」，因其在乾燥環境中保有高穩定性，若在乾血點測得製劑原態，能被視為運動員用藥的直接證據。本文結語認為乾血點在日趨多樣之禁藥濫用情事可填補現行藥檢的不足，但仍需累積更多研究開拓此新技術的多元應用，例如運動員生物護照，未來可預見在各級賽事漸進式地實施檢測，幫助維護公平競賽。

The current method for anti-doping testing in sports relies on urine analysis and venous blood samples provided by athletes. Recently, the World Anti-Doping Agency has implemented a new testing strategy: dried blood spot (DBS). This method was trialed at the Tokyo 2020 Olympic Games then officially utilized for routine testing at the 2022 Beijing Winter Olympic Games. This paper aims to explore and discuss the issue from the perspective of doping control by examining official guidelines and reports and reviewing the latest scientific research literature. The results show that DBS collection is relatively straightforward, fast, produces very little pain, and does not require medical personnel. Use of DBS testing is expected to increase. A variety of sampling devices are being developed to absorb minute amounts of blood homogeneously and let them dry, yet there is still no preference for a specific manufacturer. In terms of analysis, DBS can currently be used only for the detection of non-threshold substances without minimum reporting levels. That is, the substances prohibited in-competition and the drugs misused for therapeutic purposes are excluded. One of the greatest advantages of the DBS testing is that it can be used to detect 'anabolic steroid preparations (esters)'. These compounds are highly stable only in a dry matrix, hence the detection of their unchanged state in DBS samples can be considered as direct evidence for doping. This paper concludes that DBS can fill the unmet needs of the current testing strategy particularly in today's increasingly diverse situation of drug misuse. More research on this new technology is warranted to develop multiple applications such as the Athlete Biological Passport. DBS testing is anticipated to be implemented progressively at all levels of sports games in the future to protect fair competition.

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