Gurney Burke, Wascher Daniel, Eaton Leslie, Benesh Errin, Lucak Joseph
University of New Mexico, Physical Therapy Program, Albuquerque, NM 87131-0001, USA.
J Orthop Sports Phys Ther. 2008 May;38(5):238-45. doi: 10.2519/jospt.2008.2648. Epub 2008 Jan 22.
Experimental laboratory study.
To measure the transmission of dexamethasone sodium phosphate (DEX-P) using iontophoresis as a function of skinfold tissue thickness and time elapsed between treatment and tissue extraction.
Iontophoresis is a modality used in physical therapy with the intent to drive medications through the skin to underlying tissues using a direct electrical current. DEX-P is the most commonly used medication with iontophoresis and is used to treat a variety of connective tissue conditions.
Sixteen adults undergoing anterior cruciate ligament reconstructive surgery using the semitendinosis/gracilis autograft received a 40-mA-min dose of iontophoresis with 0.4% DEX-P superficial to a slip of the distal semitendinosis tendon prior to surgery. The tendon slip was extracted within 4 hours. Time between treatment and tissue extraction and skinfold thickness were measured. Analysis was performed on the slip of the semitendinosis using high-performance liquid chromatography mass spectrum.
Of the 16 subjects (10 female, 6 male; mean age, 33 years), 7 had measurable amounts of DEX-P in the tendon slip (4 female, 3 male; mean age, 34 years). The average concentration in the 16 subjects was 2.9 ng/g of tendon tissue. There was no correlation between DEX-P absorbed and skinfold thickness (r = -0.08, P = .79) or time elapsed (r = 0.25, P = .38). In a subset of the 7 individuals that showed measurable levels of DEX-P absorbed, the average concentration of DEX-P was 6.6 ng/g of tendon tissue, and there was a relationship between DEX-P concentrations and time elapsed that did not reach statistical significance (r = 0.71, P = .11).
Iontophoresis appears to facilitate the transmission of dexamethasone to connective tissues in humans with skinfold thickness up to at least 30 mm. The absorption of the dexamethasone seemed to continue to occur for up to 4 hours after delivery. It is not clear why DEX-P was measured in only 7 of the 16 subjects.
Therapy, level 5.
实验性实验室研究。
测量使用离子导入法时地塞米松磷酸钠（DEX-P）的透皮传输情况，作为皮褶组织厚度以及治疗与组织提取之间所经过时间的函数。
离子导入法是物理治疗中使用的一种方法，旨在通过直流电将药物透过皮肤输送到深层组织。DEX-P是离子导入法中最常用的药物，用于治疗多种结缔组织疾病。
16名接受半腱肌/股薄肌自体移植进行前交叉韧带重建手术的成年人，在手术前于半腱肌远端肌腱束表面接受了40毫安·分钟剂量的含0.4% DEX-P的离子导入治疗。在4小时内提取肌腱束。测量治疗与组织提取之间的时间以及皮褶厚度。使用高效液相色谱质谱法对半腱肌肌腱束进行分析。
16名受试者（10名女性，6名男性；平均年龄33岁）中，7人在肌腱束中检测到可测量量的DEX-P（4名女性，3名男性；平均年龄34岁）。16名受试者中的平均浓度为每克肌腱组织2.9纳克。DEX-P的吸收量与皮褶厚度（r = -0.08，P = 0.79）或经过时间（r = 0.25，P = 0.38）之间无相关性。在显示有可测量水平DEX-P吸收的7名个体的子集中，DEX-P的平均浓度为每克肌腱组织6.6纳克，DEX-P浓度与经过时间之间存在一种未达到统计学显著性的关系（r = 0.71，P = 0.11）。
离子导入法似乎有助于地塞米松向皮褶厚度至少达30毫米的人体结缔组织传输。地塞米松的吸收在给药后似乎可持续长达4小时。尚不清楚为何16名受试者中只有7人检测到DEX-P。
治疗，5级。
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