Koren G, Silverman E, Sundel R, Edney P, Newburger J W, Klein J, Robieux I, Laxer R, Giesbrecht E, Burns J C
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr. 1991 Mar;118(3):456-9. doi: 10.1016/s0022-3476(05)82168-7.
Because patients with Kawasaki disease have low serum concentrations of salicylates despite high doses, and because the free (unbound) drug is responsible for the pharmacologic effects of salicylates, we assessed salicylate protein binding in patients with Kawasaki disease. During the acute phase of the disease, protein binding of salicylate in 36 children with Kawasaki disease was 73 +/- 12%, significantly lower than during the subacute phase (90.4 +/- 8.7%; p less than 0.0005). Mean serum albumin concentration was 29.2 +/- 6.4 gm/L during the acute phase and 36.7 +/- 7.8 gm/L during the subsequent subacute phase (p less than 0.005). Salicylate protein binding was affected independently by both serum albumin and total salicylate levels. During the acute phase of Kawasaki disease, children had an average twofold increase in free salicylate compared with normoalbuminemic control subjects. A nomogram has been devised to derive free salicylate levels from the known total salicylate and serum albumin concentrations.
由于川崎病患者即便服用高剂量水杨酸酯，其血清浓度仍较低，且由于游离（未结合）药物是水杨酸酯产生药理作用的原因，因此我们评估了川崎病患者的水杨酸酯蛋白结合情况。在疾病急性期，36名川崎病患儿的水杨酸酯蛋白结合率为73±12%，显著低于亚急性期（90.4±8.7%；p＜0.0005）。急性期平均血清白蛋白浓度为29.2±6.4g/L，随后的亚急性期为36.7±7.8g/L（p＜0.005）。水杨酸酯蛋白结合受到血清白蛋白和总水杨酸酯水平的独立影响。在川崎病急性期，与正常白蛋白水平的对照受试者相比，患儿的游离水杨酸平均增加了两倍。已设计出一个列线图，可根据已知的总水杨酸酯和血清白蛋白浓度得出游离水杨酸水平。
