不同年龄患儿顺式阿曲库铵药代动力学的比较

Pharmacokinetics of cisatracurium in children of different ages

目的比较不同年龄患儿顺式阿曲库铵的药代动力学。方法择期行唇腭裂修复术的患儿24例，ASA分级Ⅰ或Ⅱ级，年龄〈5岁，体重9～26kg。根据年龄将患儿分为2组（n=12），A组：年龄〈2岁；B组：2岁≤年龄〈5岁。麻醉诱导后经10s静脉注射顺式阿曲库铵0．15mg／kg。于顺式阿曲库铵给药后2、4、6、8、10、15、20、30、45、60、90和120min时取桡动脉血样，采用高效液相色谱法检测血浆顺式阿曲库铵浓度，将所得时间．血药浓度数据应用3t07计算机软件处理，得到各项药代动力学参数：消除半衰期、系数常数（A，B）、分布速率常数、消除速率常数、中央分布容积、血浆清除率、表观分布容积、速率常数（K10、K12、K21）。结果顺式阿曲库铵药代动力学过程符合二室模型；与B组比较，A组中央分布容积、表观分布容积和血浆清除率升高（P〈0．05），其余药代动力学参数差异无统计学意义（P〉0．05）。结论患儿顺式阿曲库铵药代动力学过程符合二室模型，2岁以下患儿顺式阿曲库铵中央室分布容积、表观分布容积、血浆清除率明显高于2～5岁患儿。

Objective To study the pharmacokinetics of cisatracurium in children of different ages.Me- thods Twenty-four ASA Ⅰ or Ⅱ children undergoing elective surgery were divided into 2 age groups： group A 〈 2 yr and group B ≥ 2 yr - 〈 5 yr. Arterial blood samples were obtained at 2, 4, 6, 8, 10, 15, 20, 30, 45, 60, 90, 120 min after a bolus dose of cisatracurium （0.15 mg/kg）. Plasma concentrations （Cr ） of cisatracurium were measured by high performance liquid chromatography. The data obtained were analyzed by 3P97 pharmacokinetic software. Distribution haft-life（ t1/2a ）, elimination half life（ t1/2a ）, A, B, distribution rate constant （ a ）, elimina- tion rate constant （fl） , central volume of distribution （Vo）, total clearance （CL） and apparent volume of distribution （Vd）, Kl0, K12, K21 were recorded. Results The Cp versus time curve for cisatracurium was fitted to a two compartment pharmacokinetic model. There were no significant differences in t1/2a, t1/2β, A, B, a, β,K10, K12, K21 between the 2 groups. Group A had a significantly larger Ve, CL and Vd than group B. Conclusion The Cp versus time curve for cisatracurium is best described by a two-compartment pharmacokinetic model. Vc, CL and Vd are significantly larger in children under the age of 2 than in children between 2 and 5.