不同年龄、性别的肝功能不全患者靶控输注顺苯磺酸阿曲库胺的药效及药代学研究

Pharmacodynamics and pharmacokinetics of target controlled infusion of atracurium besylate on liver function of different age and gender

目的分析研究不同年龄、性别肝功能不全患者对靶控输注顺苯磺酸阿曲库胺药效及药代学的影响。方法将160例行择期全麻手术的肝功能不全患者根据年龄及性别分为4组,每组40例:A组(年龄≥65岁、男性),B组(年龄≥65岁、女性),C组(年龄<65岁、男性),D组(年龄<65岁、女性)。单次给予2倍ED95顺苯磺酸阿曲库胺,比较药效学指标及药代学参数。结果 4组患者阻滞起效时间、阻滞维持时间、临床作用时间T25%、体内作用时间T95%、肌松恢复指数比较,差异无统计学意义。术前及术后24h,4组患者肝功能指标(丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、白蛋白、胆红素)及肾功能指标(肌酐、尿素氮)比较,差异无统计学意义。4组患者血浆中待测物达峰浓度、达峰时间、药时曲线下面积、消除半衰期比较,差异均无统计学意义。结论对于肝功能不全患者,靶控输注顺苯磺酸阿曲库胺进行全身麻醉手术时,可以不考虑年龄、性别。

Objective To analyze the effects of different age and gender on the efficacy and pharmacokinetics of the target controlled infusion of atracurium besylate on liver dysfunction. Methods 160 case of patients with liver dysfunction and undergoing elective general anesthesia operation were divided into four groups according to their age and gender,40 cases in each group： group A（ age ≥65 years old,male）,group B（ age ≥65 years old,female）,group C（ age 65 years old,male）,group D（ age 65 years old,female）. The patients received one-time double dose ED95 atracurium besylate,pharmacodynamic indexes and pharmacokinetic parameters were compared. Results The four groups of patients with block onset time,block maintenance time,clinical duration of T25%,in vivo role time T95%,muscle relaxation recovery index were compared,the difference was not statistically significant. The preoperative and postoperative 24 h,four groups of patients with liver function（ alanine aminotransferase,aspartate aminotransferase,albumin,bilirubin） and renal function（ creatinine,urea nitrogen） were compared,the difference was not statistically significant. There was no significant difference between the four groups in the plasma concentrations of the substance to be measured,the peak time,the area under the curve and the elimination half lives. Conclusion For the patients with liver dysfunction,the target controlled infusion of atracurium besylate in general anesthesia operation,gender and age were not considered.