苯磺酸阿曲库铵对艾滋病患者肝肾功能影响的观察

The Effect of Atracurium Besilate on Liver and Kidney Function in Patients With AIDS

目的观察苯磺酸阿曲库铵对艾滋病患者的肝肾功能影响。方法选取接受有创机械通气治疗的30例AIDS患者,气管插管前予静脉注射咪达唑仑2~3 mg镇静,予苯磺酸阿曲库铵0.3~0.6 mg/kg的负荷量缓慢静脉注射以松弛呼吸肌后气管插管并应用呼吸机辅助通气,继续给予咪达唑仑0.02~0.20 mg/(kg·h)的速度镇静,芬太尼0.6~1.5μg/(kg·h)的速度镇痛,苯磺酸阿曲库铵以0.25~0.50mg/(kg·h)速度维持静脉注射,苯磺酸阿曲库铵用药时间不超过48小时。观察患者在应用苯磺酸阿曲库铵后12小时、48小时、72小时的肝功能ALT、AST、ALP、GGT、TBIL、ALB以及肾功能UREA、CREA、UA的变化。结果在应用苯磺酸阿曲库铵后12小时、48小时、72小时的肝功能ALT、AST、ALP、GGT、TBIL、ALB以及肾功能UREA、CREA、UA与用药前比较差异无统计学意义(P>0.05)。结论苯磺酸阿曲库铵对艾滋病患者的肝肾功能无明显影响,用药剂量可按常规剂量使用。

Objective To observe the efect of atracurium besilate on liver and kidney function in patients with AIDS. Methods 30 cases of AIDS patients before tracheal intubation intravenous midazolam 2-3 mg, given atracurium besilate 0.3-0.6 mg/kg load slow intravenous injection, followed by endotracheal intubation and mechanical ventilation for treatment. Then continue to give midazolam 0.02-0.20 mg/（kg·h） the speed of intravenous injection, fentanyl 0.6-1.5μg/（kg·h） the speed of intravenous injection and atracurium besilate given by 0.25-0.50 mg/（kg·h） speed of intravenous injection. The dosage of atracurium besilate was not more than 48 hours. The changes of liver function with ALT, AST, ALP, GGT, TBIL, ALB and kidney function with UREA, CREA and UA in 12 hours, 48 hours and 72 hours after application of atracurium besylate were observed. Results After the application of atracurium besylate, there was no signifcant diference in liver function with ALT, AST, ALP, GGT, TBIL, ALB and kidney function with UREA, CREA, UA between 12 hours, 48 hours and 72 hours before treatment （P 〉 0.05）. Conclusion Atracurium besilate has no obvious efect on liver and kidney function in patients with AIDS, the dosage can be used according to routine dose.