大黄对毒鼠强中毒患者代谢动力学的影响

Effect of Rhubarb on Toxicokenetics of Tetramethylene Disulphotetramine

目的探讨毒鼠强在人体内的代谢动力学特点及口服大黄后对毒鼠强代谢动力学的影响。方法代谢动力学研究分对照组和大黄组,对照组采用甘露醇导泻,大黄组采用口服大黄导泻,定时静脉取血后采用气质联用色谱法检测毒鼠强的血药浓度,并用DAS软件对数据进行代谢动力学分析。结果毒鼠强在人体内的排泄非常缓慢,对照组的AUC为31377.90ng.mL-1.h,清除率12.74mL.h-1.kg-1,大黄组排泄半衰期为AUC为8446.92ng.mL-1.h,清除率43.75mL.h-1.kg-1;两组各项参数的差异除半衰期外均具有统计学意义。大黄组的清除率相当于对照组的3.72倍,曲线下面积只有对照组的26%。结论毒鼠强在人体内排泄缓慢,口服大黄导泻能减少其吸收和加快排泄。

OBJECTIVE To explore toxicokinetics of tetramethylene disulphotetramine （TETS） in human and the effect of Rhubard on toxicokenetics of TETS. METHODS Ninty-nine patients with acute tetramine tuxieatio were randomized into mannitol group and Rhubarb group. After confirming diagnosis of patients in both groups with acute tetramiue intoxication （ATI） , Mannitol group was eatharsised with nasogostric 20% mannitol, and Rhubarb group with Rhubarb. Blood sample were taken at 0,12,24,48 and 72 hour after diagnosis. The contents of TETS in sample were determined by GS/MS method. Toxicokineties parameters of TETS were acquired by the DAS soft. RESULTS TETS was eliminated very slowly in human. The AUC of TETS was 31 377.90 ng·ml^-1·h in mannitol group and 8 446.92 ng·mL^-1·h in Rhubarb group respectively. The clearance （CI） of it was only 12.74 mL·h^-1·kg^-1 in mannitol group and 43.75 mL·h^-1·kg^-1 in rhubarb group. Except for t1/2（el） , the parameters of toxicokineties of TETS were signifieantly different between the aetivated Rhubard group and the mannitol group. Compared to the mannitol group,Cl was equal to 3.72 fold,area under the curve was equal to 26%. CONCLUSION TETS was a poison eliminated very slowly in body. The excretion of TETS eould be quiekened after activated charcoal bx Rhubarb.