通过利多卡因代谢评估囊性纤维化患者的肝功能

Assessment of hepatic function in cystic fibrosis by lidocaine metabolism.

作者信息

Gremse D A, Sindel L J, Hoff C J, Wells D J, Boerth R C

机构信息

The Department of Pediatrics, University of South Alabama College of Medicine, Mobile 36604, USA.

出版信息

J Pediatr Gastroenterol Nutr. 2001 Apr;32(4):434-7. doi: 10.1097/00005176-200104000-00008.

DOI:10.1097/00005176-200104000-00008

PMID:11396809

Abstract

BACKGROUND

To determine hepatic drug metabolism in patients with cystic fibrosis, as measured by monoethylglycinexylidide formation after lidocaine injection and indocyanine green (ICG) clearance.

METHODS

The following study is a case-control study, which included 19 patients with cystic fibrosis and 13 control subjects. Serum monoethylglycinexylidide concentration was measured after intravenous injection of 1 mg/kg (maximum, 50 mg) lidocaine. Indocyanine green (0.5 mg/kg) was injected concomitantly, and absorbance (805 nm) of serum was measured over time to determine its volume of distribution, serum half-life, and hepatic blood flow.

RESULTS

Monoethylglycinexylidide formation was decreased in patients with cystic fibrosis compared with controls (39.4+/-16.9 microg/L versus 70.3+/-45.7 microg/L, mean +/- SD, respectively, P < 0.02). Indocyanine green half-life (4.6+/-2.7 min versus 3.0+/-1.0 min), volume of distribution (8.6+/-5.5 L versus 8.3+/-3.4 L), and hepatic blood flow (10.9+/-5.9 ml x kg(-1) x min(-1) versus 7.4+/-2.0 ml x kg(-1) x min(-1)) were similar in both groups.

CONCLUSION

Monoethylglycinexylidide formation after lidocaine injection is impaired in patients with cystic fibrosis. This impairment may have clinical implications when using hepatically metabolized medications in patients with cystic fibrosis.

摘要

背景

通过利多卡因注射后单乙基甘氨酰二甲苯胺的形成以及吲哚菁绿（ICG）清除率来测定囊性纤维化患者的肝脏药物代谢。

方法

以下研究为病例对照研究，纳入了19例囊性纤维化患者和13例对照受试者。静脉注射1mg/kg（最大剂量50mg）利多卡因后测定血清中单乙基甘氨酰二甲苯胺的浓度。同时注射吲哚菁绿（0.5mg/kg），并随时间测量血清吸光度（805nm），以确定其分布容积、血清半衰期和肝血流量。

结果

与对照组相比，囊性纤维化患者单乙基甘氨酰二甲苯胺的形成减少（分别为39.4±16.9μg/L和70.3±45.7μg/L，均值±标准差，P<0.02）。两组的吲哚菁绿半衰期（4.6±2.7分钟对3.0±1.0分钟）、分布容积（8.6±5.5L对8.3±3.4L）和肝血流量（10.9±5.9ml·kg⁻¹·min⁻¹对7.4±2.0ml·kg⁻¹·min⁻¹）相似。