年龄和性别对阿曲库铵量-效关系和恢复时相的影响  

Influences of Age and Gender on Dose- response and Recovery Time- course of Atracurium

作　　者：薛富善[1] 廖旭[1] 何农[1] 张雁鸣[1] 安刚[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院麻醉科,北京100041

出　　处：《中国医学科学院学报》2001年第1期54-57,共4页Acta Academiae Medicinae Sinicae

基　　金：中国医学科学院中国协和医科大学政策性资助项目( 954006);卫生部中青年优秀人才专项基金!( 97004)&&

摘　　要：研究年龄和性别对阿曲库铵量－效关系和恢复时相特征的影响。方法选择 72例（男 38例、女 34例） ASA I级，年龄 15～ 59岁，施择期整形外科手术的患者，按年龄分成 3组：Ⅰ组， 15～ 29岁（ n=32）；Ⅱ组， 30～ 40岁（ n=21）；Ⅲ组， 41～ 59岁（ n=19）。采用 60％ NO2- O2-硫喷妥钠－芬太尼维持麻醉，用加速度仪监测神经肌肉功能，以累计给药方法建立阿曲库铵的量－效关系曲线。结果与年龄较大患者和女性患者相比，年轻患者和男性患者阿曲库铵的量－效关系曲线平行左移。用多元直线回归分析发现，年龄和性别与阿曲库铵的量－效关系密切相关。阿曲库铵的 ED50、 ED90、 ED95和应用同等剂量后的临床肌松时间以及体内作用时间在 3个年龄组和男、女患者之间差异均有显著性。结论年龄和性别对阿曲库铵的药效学具有明显影响。Objectives To evaluate the influences of age and sex on dose- response and recovery time course of atracurium. Methods Seventy- two patients (38 men and 34 women), ASA gradeⅠ , aged 15～ 59 years, scheduled for elective surgery were included in the study. All patients were divided into three groups according to their ages: Group 1, 32 patients aged 15～ 29 years; Group 2, 21 patients aged 30～ 40 years, and Group 3, 19 patients aged 41～ 59 years. General anesthesia was maintained with 60％ nitrous oxide in oxygen, thiopentone and fentanyl. Neuromuscular function was assessed by train- of- four(TOF) stimulation of accelerometry and the percentage depression of the first response (T1) of the TOF stimulus was used as the study parameter. The dose- response relations of atracurium were determined by the cumulative dose- response technique. Results As compared to older and female patients, dose- response curves of atracurium in young and male patients were shifted in a parallel fashion to the left. The dose- response relation of atracurium correlated closely with patients′ ages and sexes by multiple linear regression analysis. There were significant differences of ED50、 ED90 and ED95, and clinical duration and total duration of action following administration of atracurium of same doses between the three age groups as well as men and women. Conclusions Age and gender could significantly affect the pharmacodynamics of atracurium.

关 键 词：阿曲库铵 量效关系 恢复时相 年龄 性别 

分 类 号：R971.8[医药卫生—药品] R969.4[医药卫生—药学]