咪达唑仑、异丙酚与阿芬太尼联合催眠作用的模型化评价  

Modeling based evaluation of the hypnotic and anaesthetic interactions between midazolam,propofol and alfentanil

作　　者：王晶晶[1] 尹芳[1] 陈君超[1] 吕映华[1] 刘红霞[1] 郑青山[1] 

机构地区：[1]上海中医药大学药物临床研究中心,上海201203

出　　处：《中国临床药理学杂志》2016年第7期646-648,共3页The Chinese Journal of Clinical Pharmacology

基　　金：上海市中医药事业发展三年行动计划基金资助项目(ZY3-CCCX-3-1001);上海市中药学一流学科创新研究基金资助项目(ZYX-CXYJ-003);上海市支持基金资助项目(085ZY1202);上海市教委预算内科研基金资助项目(2013JW19)

摘　　要：目的 3个临床麻醉药咪达唑仑(X_1)、异丙酚(X_2)与阿芬太尼(X_3)单用和不同组合联用,可使手术病人获得不同的催眠作用。由于其间存在复杂的相互作用,已有的研究尚未完全阐明,有必要重新进行定量评价。方法本研究基于文献数据,采用权重配方模型进行定量分析和模拟研究,寻找临床优化组方。结果权重配方模型成功地建立,显示3个组分均存在明显的量效关系,其中X_3>X_2>X_1,彼此间有较强的协同作用;联合使用的量效曲线较陡,受试者对联合用药敏感,易于获得满意疗效。通过基于最终模型的模拟,列出了若干种临床用药方案供临床选择应用。结论权重配方模型可以有效地应用于麻醉药相互作用分析,可提供临床联合用药所需的各类信息。Objective To reevaluate the hypnotic interactions between midazolam,propofol and alfentanil by the approach of modeling and simulation. Methods The weighted modification model was used to analyze the interactions among the three drugs based on the data from a published paper,and then the simulations of doses were conducted for combinations. Results The model was fitted to the data successfully,and indicated that the three drug presented an apparent dose- effect relationship with alfentanil 〉propofol〉 midazolam. The strong synergy existed among the three drugs. The subjects showed a significant response to the combinations. The simulations displayed the schemes of combinations for clinical practice. Conclusion The weighted modification model is a valid approach to identify optical combinations for guiding rational administration of the three drugs, and the model can fully interpret the characteristics of interactions.

关 键 词：咪达唑仑 异丙酚 阿芬太尼 药物相互作用 协同 权重配方模型 

分 类 号：R971.2[医药卫生—药品]