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异丙酚Marsh药代动力学参数的临床评价 被引量:7

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摘要 目的通过反映血浆预测浓度与实测浓度差异的相关指标对异丙酚靶控输注(TCI)系统Marsh参数进行评价,为靶控输注系统的临床应用提供理论依据。方法选择15例美国麻醉医师协会(ASA)Ⅰ~Ⅱ级并符合纳入标准的择期行腹腔镜胆囊切除术(LC)患者。入室后分别行桡动脉、肘静脉穿刺置管测压和建立静脉通道,在30min内输入10mL/kg复方乳酸林格氏液生理需要量后,Graseby3500以异丙酚靶浓度3μg/mL行TCI。受试者接受恒定靶浓度3μg/mL变速输注异丙酚60min,于TCI开始后2.5、5、7.5、10、15、20、30、40、50、60、62.5、65、67.5、70、75、80、90min各时点采桡动脉血2mL,将样本置于-70℃深低温冰箱保存。应用气相色谱-质谱仪(GC-MS)测定异丙酚血药浓度。结果Graseby3500TCI靶血浆药物浓度达稳态约2.5min。靶控期间及靶控停止后异丙酚实测浓度均高于预测浓度(P<0.05),前者高74.7%~113.9%,后者高30.5%~48.4%。靶控期间系统偏离度、精确度及摆动度分别为91.1%、91.1%及25.1%;停止靶控后为41.9%、41.9%及16.5%。在靶控期间,Graseby3500TCI达稳态血药浓度后各时点实测浓度间差异无统计学意义,实、预测浓度间呈平行关系;在靶控停止后,二者间呈线性相关(r2=0.9625,P<0.01)。结论异丙酚Marsh药代动力学参数应用于国人群体产生较大误差。临床应用时可考虑将Graseby3500TCI的设定点下调来近似达到预期血药浓度。
出处 《四川大学学报(医学版)》 CAS CSCD 北大核心 2009年第5期946-948,共3页 Journal of Sichuan University(Medical Sciences)
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