摘要
目的研究梗阻性黄疸患者吗啡-红细胞载体(RBC-M)静脉注射的药代动力学特征。方法20例择期拟行腹部探查手术的梗阻性黄疸患者随机均分为研究组(T组)和对照组(C组)。T组和C组手术结束时分别静注RBC-M溶液(含吗啡2mg/kg)和单纯吗啡溶液(2mg/kg)。记录术后患者首次出现手术部位疼痛的时间。两组中随机选取5例患者进行药代动力学研究,采用高效液相色谱法测定并计算药代动力学参数。结果T组和C组患者术后手术部位首次出现疼痛的时间分别为(2.6±1.5)h和(5.1±2.7)h(P<0.01)。两组均符合二室模型,T组吗啡的血浆清除率(CL)为(518.1±165.4)ml/min,消除半衰期(T1/2β)为(4.6±1.8)h,平均驻留时间(MRT)为(6.8±2.4)h,血药浓度时间曲线下面积(AUC)为(321.7±102.6)ng·h-1·L-1;C组的CL为(282.6±96.8)ml/min,T1/2β为(3.7±1.3)h,MRT为(5.3±2.1)h,AUC为(589.5±114.6)ng·h-1·L-1。两组药代动力学参数之间的差异均有统计学意义(P<0.01)。结论将红细胞载体应用于梗阻性黄疸患者可显著延长吗啡的作用时效。
Objective To investigate the pharmacokinetics of morphine loaded with erythrocytes （RBC-M） in the patients with obstructive jaundice. Methods Twenty patients with obstructive jaundice undergoing selective upper abdominal surgeries were randomly allocated into, test group（T） and control group（C） with 10 cases each. At the end of operation, the patients in group T received intravenous RBC-M solutions （morphine 2 mg/kg） and those in group C plain morphine solutions （2 mg/kg）. The time of the first pain experience after drug injection was recorded. The blood sample from 5 patients in each group were taken for detecting morphine concentration by HPLC. The pharmacokinetic parameters of RBC-M were then calculated by 3P97 software. Results The times of the first pain experience in group T and C were （2.6 ± 1.5） h and （5.1 ± 2.7） h, respectively （P〈0. 01）. The plasma concentrations versus time curves for both RBC-M and morphine were all well described by a two-compartment pharmacokinetic model. The CL of RBC-M solutions was （518. 1±165.4） ml/min,T1/2β （4.6±1.8） h,MRT （6.8±2.4） h, AUC （589.5±114.6） ng · h^-1 · L^-1.The CL of morphine was （282.6±96.8） ml/min, T1/2β（3.7±1. 3） h, MRT（5.3± 2.1） h, AUC was （589.5±114.6） ng · h^-1 · L^-1 ,which were all significantly different between the two groups （P〈 0.01）. Conclusion The application of carrier erythrocytes in the patients with obstructive jaundice can significantly prolong the duration of action of morphine.
出处
《临床麻醉学杂志》
CAS
CSCD
2007年第10期809-811,共3页
Journal of Clinical Anesthesiology
关键词
吗啡
红细胞
载体
药代动力学
Morphine
Erythrocyte
Carrier
Pharmacokinetics
