布依族与汉族患者罗库溴铵肌松时效的比较  

Difference in rocuronium-induced muscle relaxation between patients of Buyi and Han nationality

作　　者：王世萍[1] 章放香[1] 张伟晶[1] 黄盛文[2] 蒋克东[1] 张丽华 

机构地区：[1]贵州省人民医院麻醉科,贵阳市550002 [2]贵州省人民医院检验科,贵阳市550002 [3]黔南州人民医院麻醉科

出　　处：《中华麻醉学杂志》2012年第4期454-456,共3页Chinese Journal of Anesthesiology

基　　金：贵州省优秀省长基金（黔省专20100152号）

摘　　要：目的比较布依族与汉族患者罗库溴铵的肌松时效。方法择期全麻下行腔镜或关节镜手术患者60例，性别不限，年龄20～55岁，体重指数18～25kg／m2，ASA分级Ⅰ或Ⅱ级，按民族分为2组（n=30）：汉族组（H组）和布依族组（B组）。静脉注射咪达唑仑和芬太尼，靶控输注异丙酚行麻醉诱导。待患者意识消失后进行肌松定标，采用加速度仪单个刺激模式，肌颤搐达最大抑制时静脉注射罗库溴铵0．6mg／kg，气管插管行机械通气，维持PETc0230～35mmHg。记录肌松起效时间、无反应期、临床作用时间、75％恢复时间和恢复指数。采用ELISA法测定血浆％．酸性糖蛋白浓度，采用生化法测定血浆白蛋白浓度。结果与H组比较，B组肌松起效时间延长，血浆α1-酸性糖蛋白浓度降低（P〈0．05），无反应期、临床作用时间、75％恢复时间、恢复指数和血浆白蛋白浓度差异无统计学意义（P〉O．05）。结论布依族患者较汉族患者罗库溴铵肌松起效慢，可能与布依族患者血浆α1-酸性糖蛋白浓度较低有关。Objective To detennine whether there is any difference in rocuronium-induced muscle relaxation between patients of Buyi and Han nationality. Methods Sixty ASA Ⅰ or Ⅱ patients of beth sexes aged 20- 55 yr, with body mass index of 20-25 kg/m2, undergoing laparoscopie or arthroscopie surgery under general anesthesia, were divided into 2 groups （ n = 30 each） ： Han group （group H） and Buyi group （group B）. Anesthesia was induced with midazolam, fentanyl and TCI of propofol （Cp = 2-3 μg/ml）. Tracheal intubation was facilitated with rocuronium 0.6 mg/kg. The patients were mechanically ventilated. PETCO2 Was maintained at 30-35 mm Hg. Neuro-muscular （N-M） function was monitored by aceelerography. N-M block was assessed by single stimMation of ulna nerve after loss of consciousness. The onset time, maximal N-M block time, clinical muscle relaxation time （from injection of rocuronium to 25 % recovery）, 75 % recovery time （from injection of rocuronium to 75 % recovery） and recovery index were recorded. The plasma concentration of albumin and α1-acid glycoprotein were measured by ELISA and biochemical analysis respectively. Results The onset time was significantly longer and plasma α1-acid glyeoprotein concentration lower in group B than in group H. There was no significant difference in maximal N-M block time, clinical muscle relaxation time, 75 % recovery time, recovery index and plasma albumin concen- tration between the 2 groups. Conclusion The onset time of rocuronium-induced N-M block is longer in patients of Buyi nationality as compared with patients of Han nationality. Lower plasma α1-acid glyeoprotein concentration may be involved in the underlying mechanism.

关 键 词：雄甾烷醇类 人种群 汉族 神经肌肉阻滞 

分 类 号：R614[医药卫生—麻醉学]