目的

分析2023 年全国中毒医疗应急毒物检测实验室间比对的血液中抗精神失常药物检测结果，评价参加实验室的毒物检测能力。

方法

将氯氮平、氟奋乃静和氟哌啶醇作为比对检测化合物，经口灌胃染毒雄性新西兰兔，分4 组染毒剂量，每组含2 种药物，分别为低剂量氯氮平+氟哌啶醇、低剂量氟奋乃静+氯氮平、高剂量氟奋乃静+氯氮平和高剂量氯氮平+氟哌啶醇。染毒1 h 后采集兔血浆作为比对样品并通过冷链发送给64 家参加实验室。综合定性结果、定量结果、原始记录、提交材料完整性和样品检测时间5 个方面的评判，将实验室间比对结果分为优秀、合格、基本合格和不合格。

结果

64 家参加实验室中，60 家反馈了结果，结果反馈率为93.75%。60 家参加实验室中，比对结果优秀7 家、合格42 家、基本合格7 家、不合格4 家，优秀率11.67%、合格率（包括优秀、合格、基本合格）为93.33%。综合医院、疾病预防控制中心和职业病防治院的合格率分别是13/15、92.59%（25/27）和17/17。

结论

血液中抗精神失常药物定性、定量检测水平总体较好，但中毒医疗应急毒物检测的标准化、规范化建设和质量控制体系仍有待加强。

Objective

To analyze the detection results of antipsychotic drugs in blood among national medical emergency toxicology testing laboratories in 2023， and to evaluate the poison detection capabilities of participating laboratories.

Methods

Clozapine， fluphenazine and haloperidol were used as comparative detection compounds.Male New Zealand rabbits were poisoned by oral gavage in four doses， each containing two drugs， namely low-dose clozapine +haloperidol， low-dose fluphenazine + clozapine， high-dose fluphenazine + clozapine and high-dose clodiapine + haloperidol.Plasma was collected as comparative samples 1 h after exposure and sent to 64 participating laboratories via the cold chain transportation.Based on the evaluation of qualitative results， quantitative results， original records， integrity of submitted materials and sample testing time， the comparison results among laboratories were divided into excellent，qualified， basically qualified and unqualified.

Results

Among the 64 participating laboratories，60 gave feedback on the detection results， with a feedback rate of 93.75%.Among the 60 participating laboratories， 7 were excellent， 42 were qualified， 7 were basically qualified and 4 were unqualified， with an excellence rate of 11.67% and a passing rate （including excellent，qualified and basically qualified） of 93.33%.The passing rates of general hospitals， disease control and prevention centers and occupational disease prevention and control institutes were 13 / 15，92.59% （25/27） and 17/17 respectively.

Conclusion

The qualitative and quantitative testing of antipsychotic drugs in blood is generally good， but the standardized and normative construction of medical emergency poison detection and its quality control system should be strengthened.