先心病患者体外循环对舒芬太尼药代动力学的影响  

Effect of cardiopulmonary bypass on the pharmacokinetics of sufentanil in patients with congenital heart disease

作　　者：徐凯智[1] 赵昕[1] 李宇虹[1] 许艳荣[1] 邢彦杰[1] 杨莉[1] 

机构地区：[1]河北医科大学唐山工人医院麻醉科,河北唐山063000

出　　处：《中国临床药理学杂志》2012年第8期591-593,共3页The Chinese Journal of Clinical Pharmacology

基　　金：唐山市新药与临床医学研究计划基金资助项目(07130206A-4-7)

摘　　要：目的研究先心病心内矫治术患者低温体外循环对舒芬太尼药代动力学的影响。方法随机选择NYHAⅡ～Ⅲ级的先心病手术患者16例,分为先心病普通手术组(n=7)和体外循环下先心病矫治手术组(n=9)。入室后建立前臂静脉通路,麻醉后一次性静脉注射舒芬太尼5μg.kg-1。在静脉注射舒芬太尼后1,3,5,10,20,30,60,120,240,360 min采肝素抗凝血浆1 mL。用液相色谱-质谱联用法测定血药浓度,3P97药理学程序计算药代动力学参数。结果 2组患者药代动力学可用三室模型完整描述,其三指数函数方程分别为:Cp(t)=16.6e-1.786t+6.6e-0.171t+0.23e-0.025t和Cp(t)=12.8e-0.457t+3.3e-0.046t+0.4e-0.0048t,2组的t1/2π,t1/2α,t1/2β,Vc,Vd,CL和AUC差异有统计学意义(P<0.01或P<0.05)。结论舒芬太尼在先心病患者药代动力学可用三室模型描述,低温体外循环血液稀释可影响其药代动力学特征。Objective To study effect of cardiopulmonary bypass on the pharmacokinetics of sufentanil in patients with congenital heart disease （CHD）. Methods Sixteen NYHA grade Ⅱ or Ⅲpatients with CHD undergoing surgery were divided into general surgery group （n = 7 ） and cardiac surgery group （n = 9）. Intravenous and intra - arterial cannulae were placed. After general anesthesia sufentanil 5 μg .kg- 1 was administered as a rapid bolus intravenously. Blood samples were obtained at 1, 3, 5, 10, 20, 30, 60, 120, 180, 240,360 rain after sufentanil injection. Plasma sufentanil concentrations were determined by liquid chromatography- mass spectrometry, pharmacokinetie parameters were calculated by 3P97 pharmacological program. Results Pharmacokinetics ofsufentanil fitted to three -compartment equation were Cp（t）=16.6e-1.786t＋6.6e-0.171t＋0.23e-0.025t and Cp（t）=12.8e-0.457t＋3.3e-0.046t＋0.4e-0.0048t, respectively. There were significant difference in t1/2π,t1/2α,t1/2β,Vc,Vd,CL and AUC between two groups （P 〈 0.01 or P 〈 0.05 ）. Conclusion Pharrnacokineties of domestic sufentanil in patients with CHD were fitted to three - compartment open models, cardiopulmonary bypass（CPB） and hemodilution can affect its pharmacokinetics characteristics.

关 键 词：舒芬太尼 先天性心脏病 麻醉 体外循环 药代动力学 

分 类 号：R969.1[医药卫生—药理学] R614[医药卫生—药学]