临床实践中正确认识和使用曲安西龙  

Correct Understanding and Use of Triancilone in Clinical Practice

作　　者：刘燕[1] 任雷鸣 任雪姣[3] LIU Yan;REN Leiming;REN Xuejiao(Department of Anesthesiology,the Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China;Department of Pharmacology,Institute of Integrative Chinese and Western Medicine,Shijiazhuang,Hebei 050000,China;Department of Radiotherapy,the Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北医科大学第四医院麻醉科,河北石家庄050000 [2]中西医结合研究所药理室,河北石家庄050000 [3]河北医科大学第四医院放疗科,河北石家庄050000

出　　处：《中国医药指南》2025年第3期58-62,共5页Guide of China Medicine

基　　金：河北省卫生和计划生育委员会科研基金项目(20240168)。

摘　　要：曲安西龙片剂在中国临床应用已经有28年的历史,但是国内文献和书籍对曲安西龙制剂、曲安西龙适应证及其药代动力学缺乏介绍。为了提高曲安西龙临床合理用药水平,本研究对国内外相关文献进行了收集和分析。亚裔人群口服曲安西龙片后,其血浆峰浓度(Cmax)、达峰时间(Tmax)、消除t_(1/2)和曲线下面积(AUC)分别是(109±24)ng/mL、(2.1±0.4)h、4.56h和(416±110)ng·h/mL。曲安西龙片口服吸收的生物利用度推测为23%左右。曲安西龙主要与血浆白蛋白结合,其结合率低于氢化可的松。曲安西龙口服剂量的27.8%通过尿液排泄;与氢化可的松、泼尼松龙和地塞米松等在尿液中存在相对大量的代谢产物不同,曲安西龙主要以原型由肾脏排泄,曲安西龙的代谢产物可能包括11-酮曲安西龙、4,5-双氢曲安西龙和6β-羟基曲安西龙。曲安西龙片剂的临床适用范围非常广泛,但临床医师在使用时仍应严格掌握其适应证。Triamcinolone tablets have been used for 28 years in China,but there is a lack of knowledge about the preparations,indications and pharmacokinetics of triamcinolone in Chinese literature and books.In order to improve the level of clinical rational use of triancilone,the relevant literature at home and abroad was collected and analyzed.After oral administration of triamcinolone tablets in an Asian population,its maximal plasma concentration(Cmax),the mean time of Cmax(Tmax),the elimination t_(1/2) and the area under concentration time curve(AUC)are(109±24)ng/mL,(2.1±0.4)hours,4.56 hours and(416±110)ng·h/mL,respectively.The bioavailability of oral absorption of triamcinolone tablets is estimated to be 23%.Triamcinolone mainly binds to plasma albumin,with a lower binding rate than hydrocortisone.27.8%of the oral dose of triamcinolone is excreted through urine.Unlike the metabolites in relatively large amounts in urine after administration of hydrocortisone,prednisolone or dexamethasone,triamcinolone is mainly excreted by the kidneys in its unchanged form.The metabolites of triamcinolone may include 11-ketotriamcinolone,4,5-dihydrotriamcinolone and 6β-hydroxytriamcinolone.The range of triamcinolone tablet indications is very wide,but physicians should strictly comply with the drug indications when apply triamcinolone tablets.

关 键 词：糖皮质激素 曲安西龙 曲安奈德 适应证 

分 类 号：R969[医药卫生—药理学]