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- 2016
右美托咪定在不同肥胖程度患者体内药代动力学研究
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Abstract:
摘要 目的：观察并比较右美托咪定在不同肥胖程度患者体内的药代动力学特点.方法：在全身麻醉(全麻)下行腹腔镜Roux-en-Y胃旁路手术的择期患者24例,美国麻醉医师协会(ASA)Ⅰ-Ⅱ级,根据患者的体质量指数(body mass index, BMI)将患者分为3组:正常体质量组(n=8,A组),18 kg/m2≤BMI≤24 kg/m2;普通肥胖组(n=8,B组),28 kg/m2≤BMI≤35 kg/m2;病态肥胖组(n=8,M组),40 kg/m2≤BMI≤50 kg/m2.所有患者于诱导前经右侧颈内静脉恒速泵注右美托咪定(1μg/kg) 10 min,分别于停止泵注后的0、 5、 10、 15、 20、 25、 30、 45、 60、 90、 120、 180、 240、 360、 480 min从左侧桡动脉采集血样3 mL,采用高效液相色谱-质谱联用法(HPLC-MS/MS)检测血浆中右美托咪定浓度,DAS 3.0计算药动学参数.结果：24例患者右美托咪定的药动学特征符合二房室开放模型.3组间右美托咪定的药物分布半衰期(t1/2α)比较差异无统计学意义(P>0.05),而药物峰浓度(Cmax)和药物曲线下面积(AUC)差异有统计学意义(P<0.05).B组与A组相比表观清除率(CLz)、表观分布容积(Vz)以及消除半衰期(t1/2β)的差异均无统计学意义(P>0.05),M组分别与A、B两组相比,CLz、Vz和t1/2β的差异均有统计学意义(P<0.05).结论：右美托咪定在不同肥胖程度患者的药代动力学特征均符合二房室开放模型,且随着肥胖程度的增加,右美托咪定的Cmax增加,Vz增大且t1/2β延长.
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