Woodhouse K
University Department of Geriatric Medicine, University of Wales College of Medicine, Cardiff Royal Infirmary, UK.
Biopharm Drug Dispos. 1992 Jul;13(5):311-20. doi: 10.1002/bdd.2510130502.
The clearance of many drugs by the liver is reduced in the elderly, and this accounts, at least in part, for the greater frequency of adverse drug reactions in this population. Ageing in experimental animals is accompanied by a decline in the activities of certain microsomal monooxygenase enzymes; this has been said to be the reason for decreased drug elimination. However, recent data suggests that this is probably not the case in humans. Reduced size and blood flow are important features of the ageing liver, and probably account for most of the age-related changes in drug metabolism. Major decrements in hepatic function do occur in frail elderly individuals, although the mechanisms underlying this are at present unclear. Future studies of drug metabolism and ageing must carefully define patient groups to allow full interpretation of data.
老年人肝脏对许多药物的清除率降低，这至少在一定程度上解释了该人群中药物不良反应发生率较高的原因。实验动物衰老时，某些微粒体单加氧酶的活性会下降；据说这就是药物消除减少的原因。然而，最近的数据表明，人类可能并非如此。肝脏体积减小和血流量减少是肝脏衰老的重要特征，可能是药物代谢中大多数与年龄相关变化的原因。体弱的老年人确实会出现肝功能大幅下降，尽管其潜在机制目前尚不清楚。未来关于药物代谢与衰老的研究必须仔细界定患者群体，以便对数据进行全面解读。
