中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2013年
5期
573-575
,共3页
依托咪酯%药代动力学%输注,静脉内
依託咪酯%藥代動力學%輸註,靜脈內
의탁미지%약대동역학%수주,정맥내
Etomidate%Pharmacokinetics%Infusions,intravenous
目的 评价患者静脉输注依托咪酯的群体药代动力学.方法 择期全麻患者29例,年龄25~82岁,以60μg·kg-1·min-1速率持续静脉输注依托咪酯,直至脑电双频谱指数值<40.于输注依托咪酯前、持续输注1、3、5 min及停药即刻、停止输注后1、3、5、7、10、20、30、45、75、120、180、240、300和360 min时取桡动脉血样,测定血浆药物浓度.采用NONMEM软件建立依托咪酯群体药代学模型,分析年龄、身高、体重等协变量的影响.参数个体间变异性和残差变异性分别采用指数模型和相加误差模型描述,模型改善的统计学标准依据目标函数判断.结果 依托咪酯药代学适合用三室模型描述,年龄是系统清除率C L1的影响因素.依托咪酯药代学参数典型值为:V1=4.7 L,V2=11 L,V3=123L,CL1=1.28-0.0119×[年龄(岁)-55] L/min,CL2=1.25 L/min和CL3=1.08 L/min.输注时间敏感性半衰期随年龄和稳态输注时间的增加而升高(P<0.05).结论 依托眯酯药代学适合用三室模型描述,年龄因素影响系统清除率.
目的 評價患者靜脈輸註依託咪酯的群體藥代動力學.方法 擇期全痳患者29例,年齡25~82歲,以60μg·kg-1·min-1速率持續靜脈輸註依託咪酯,直至腦電雙頻譜指數值<40.于輸註依託咪酯前、持續輸註1、3、5 min及停藥即刻、停止輸註後1、3、5、7、10、20、30、45、75、120、180、240、300和360 min時取橈動脈血樣,測定血漿藥物濃度.採用NONMEM軟件建立依託咪酯群體藥代學模型,分析年齡、身高、體重等協變量的影響.參數箇體間變異性和殘差變異性分彆採用指數模型和相加誤差模型描述,模型改善的統計學標準依據目標函數判斷.結果 依託咪酯藥代學適閤用三室模型描述,年齡是繫統清除率C L1的影響因素.依託咪酯藥代學參數典型值為:V1=4.7 L,V2=11 L,V3=123L,CL1=1.28-0.0119×[年齡(歲)-55] L/min,CL2=1.25 L/min和CL3=1.08 L/min.輸註時間敏感性半衰期隨年齡和穩態輸註時間的增加而升高(P<0.05).結論 依託瞇酯藥代學適閤用三室模型描述,年齡因素影響繫統清除率.
목적 평개환자정맥수주의탁미지적군체약대동역학.방법 택기전마환자29례,년령25~82세,이60μg·kg-1·min-1속솔지속정맥수주의탁미지,직지뇌전쌍빈보지수치<40.우수주의탁미지전、지속수주1、3、5 min급정약즉각、정지수주후1、3、5、7、10、20、30、45、75、120、180、240、300화360 min시취뇨동맥혈양,측정혈장약물농도.채용NONMEM연건건립의탁미지군체약대학모형,분석년령、신고、체중등협변량적영향.삼수개체간변이성화잔차변이성분별채용지수모형화상가오차모형묘술,모형개선적통계학표준의거목표함수판단.결과 의탁미지약대학괄합용삼실모형묘술,년령시계통청제솔C L1적영향인소.의탁미지약대학삼수전형치위:V1=4.7 L,V2=11 L,V3=123L,CL1=1.28-0.0119×[년령(세)-55] L/min,CL2=1.25 L/min화CL3=1.08 L/min.수주시간민감성반쇠기수년령화은태수주시간적증가이승고(P<0.05).결론 의탁미지약대학괄합용삼실모형묘술,년령인소영향계통청제솔.
Objective To determine the population pharmacokinetics of intravenous etomidate infusion in adult patients.Methods Twenty-nine ASA Ⅰ or Ⅱ patients of both sexes aged 25-82 yr weighing 45-80 kg received contant-rate infusion of etomidate at 60 μg· kg-1 · min-1 until BIS value dropped to ≤ 40.Arterial blood samples were obtained from radial artery for determination of plasma etomidate concentration before,at 1,3,5 min of continuous etomidate infusion and at 1,3,5,7,10,20,30,45,75,120,180,240,300 and 360 min after termination of etomidate infusion.Population pharmacokinetic model was established by using the software package NONMEM.Population pharmacokinetic parameters were calculated according to etomidate concentrations and covariates including age,height,bodyweight,sex,liver-kidney function etc.using software package NONMEM.Results Pharmacokinetics of etomidate was best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).The typical parameters were:V1 =4.7 L,V2 =11 L,V3 =123L,CL1 =1.28-0.0119 × (Age (yr)-55) L/min,CL2 =1.25 L/min and CL3 =1.08 L/min respectively.Context-sensitive half-time increased with age and steady-state infusion time.Conclusion Pharmacokinetics of etomidate is best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).