不同地域患者罗库溴铵药效学的比较——多中心研究  

Difference in pharmacodynamics of rocuronium among patients from different geographic regions： a multicenter study

作　　者：安刚[1] 肖昭扬[1] 李宝珠[1] 黄磷[1] 魏芳[1] Ashnaf A. Dahaba Henry Bennett Aryeh Shander Helfried Metzler Peter H. Rehak 

机构地区：[1]大连医科大学附属第一医院麻醉科,116011 [2]Graz Medical University, Austria [3]Englewood Medical Center, USA

出　　处：《中华麻醉学杂志》2007年第3期229-231,共3页Chinese Journal of Anesthesiology

摘　　要：目的比较中国、奥地利和美国3个不同地域的当地患者罗库溴铵作用的量效关系和时效关系。方法选择中国大连、美国英格伍德、奥地利格拉茨3个医学中心择期手术患者各18例,异丙酚、芬太尼静脉麻醉诱导后,累积剂量法进行药效学观察,首剂静脉注射罗库溴铵50μg/kg,起效后重复首剂静脉给药6次,再静脉注射罗库溴铵300μg,采用肌机械运动监测仪记录肌肉收缩强度,对数剂量．概率单位绘制剂量-反应曲线。比较3个地域患者罗库溴铵的ED50、ED90和ED95以及Dur25和Dur0．8。结果大连和格拉茨患者罗库溴铵的ED50、ED90和ED95均高于英格伍德患者,格拉茨患者的ED50、ED90和ED95高于大连患者（P＜0．05）;大连和格拉茨患者的Dur25和Dur0．8均短于英格伍德患者（P＜0．05）,格拉茨患者的Dur25短于大连患者（P＜0．05）,但两者Dur0．8的差异无统计学意义（P＞0．05）。结论3个地域患者罗库溴铵作用的量效关系和时效关系有明显的差别,临床用量需要考虑地域因素的影响。Objective To compare the potency and duration of action of rocuronium bromide in patients from three countries -P. R. China （ Han nationality ）, U. S. A, （Caucasians） and Austria （Caucasians） . Methods The 1st affiliated hospital of Dalian Medical University （P. R. China）, Englewood Medical Center （U.S.A.） and Graz Medical University （Austria） took part in this study. Eighteen ASAⅠ or Ⅱ patients （9 male, 9 female） aged 30-50 yr from each medical center were studied. Anesthesia was induced with fentanyl 1.5μg/kg and propofol 2-3 mg/kg. Laryngeal mask airway （LMA） was inserted and the patients were mechanically ventilated. Anesthesia was maintained with intravenous infusion of propofol （ 100-150 μg·kg^-1·min^-1） and remifentanil （0.1-0.3 μg·kg^-1·min^-1 ）. Six consecutive incremental doses of rocuronium 50 μg/kg were given. T1 was recorded after each dose. After the 6th dose, rocuronium 300 μg/kg was given. The responses of the adductor pollicis muscle to train-of-four （TOF） stimulation of ulnar nerve were measured and recorded with relaxometer mechanomyograph （Holland）. Dose-response curves were created using log-dose-probit transformation ED50, ED90 and ED95 （effective doses required for 50% , 90% and 95% T1 depression respectively） and Dur 25 and Dur 0.8 （the time from the administration of the last dose to the recovery of T1 = 25% and T4/T1 = 0.8） of rocuronium were compared among the patients from the 3 countries. Results ED50, ED90 and ED95 of rocuronium were significantly higher in Chinese patients [（201 ± 59）, （413 ± 107） and （475 ± 155）μg/kg] and Austrian patients [（258 ± 68）, （530 ± 159） and （598 ± 189 ）μg/kg] than in American patients [（148 ± 48）, （316 ± 116） and （362 ± 149μg/kg） ]. Dur 25 and Dur 0.8 were significantly shorter in Chinese patients [ （30 ± 8） and （46 ± 16） mini and Austrian patients [（22 ± 6） and （37 ± 13） mini than in American patients [（37 ± 8） an

关 键 词：雄甾烷醇类 剂量效应关系 药物 神经肌肉阻滞 地理位置 

分 类 号：R686[医药卫生—骨科学]