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[兔严重烧伤不同病理阶段丙泊酚的药代动力学差异]

[Pharmacokinetics differences of propofol during different pathological stages of severe burn in rabbits].

作者信息

Hu Qing-gang, Hao Jian-hua, Chai Jia-ke, Yang Hong-ming, Sun Xue-feng, Li Ping, Li Meng-meng, Liu Su

机构信息

Burns Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2010 Feb;26(1):37-40.

Abstract

OBJECTIVE

To investigate the characteristics and differences of propofol pharmacokinetics in shock phase and hypermetabolic phase in severe burn in rabbits.

METHODS

Twenty New Zealand rabbits were assigned to burn group (n = 10) and sham injury group (n = 10) according to the random number table. Rabbits in burn group were inflicted with 30%TBSA full-thickness scald (named burn below), resuscitated instantly, and were intravenously injected with 5.1 mg/kg propofol 6 hours after injury. 1.5 mL blood was collected from left external jugular vein at 1, 3, 5, 10, 15, 20, 30, 45, 60, 90 minute(s) after injection respectively. Above procedure was performed again 1 week later. Rabbits in sham injury group were treated similarly as rabbits in burn group but were sham scalded. Propofol concentration in plasma was determined with high performance liquid chromatography. Data of propofol concentration-time were analyzed with 3P97 practical pharmacokinetics calculating program, and then the most fit compartment model was selected to calculate pharmacokinetic parameters.

RESULTS

The blood concentration-time curve of propofol fitted in with the two-compartment model in burn group, and three-compartment model in sham injury group. During shock phase, comparing with central compartment distribution volume [Vc, (3.1 + or - 1.5) L/kg], area under curve [AUC, (25 + or - 7) mg x min x L(-1)], elimination phase half life [t1/2beta, (113 + or - 93) min], clearance [CLs, (110 + or - 50) mL x kg(-1) x min(-1)] of rabbits in sham injury group, Vc[(8.8 + or - 4.2) L x kg(-1)] and AUC [(44 + or - 10) mg x min x L(-1)] increased significantly (with t value respectively 3.191 and 3.668, and P values both below 0.01); t1/2beta [(339 + or - 258) min] prolonged (t = 2.932, P < 0.05); CLs [(40 + or - 30) mL x kg(-1) x min(-1)] decreased (t = -3.013, P < 0.05) in burn group. During hypermetabolic phase, CLs [(180 + or - 40) mL x kg(-1) x min(-1)] of rabbits in burn group was significantly higher than that in sham injury group [(90 + or - 30) mL x kg(-1) x min(-1), t = -3.013, P < 0.05]. Comparing with those of rabbits in burn group during shock phase, Vc [(4.1 + or - 1.3) L/g] and AUC [(24 + or - 5) mg x min x L(-1)] decreased significantly (with t value respectively 2.979 and 3.766, and P value both below 0.01); distribution phase half time [t1/2alpha, shock phase (16.1 + or - 13.1) min and hypermetabolic phase (8.3 + or - 2.5) min] and t1/2beta [(55 + or - 19) min] shortened obviously (with t value respectively 9.065 and 8.795, and P values both below 0.01); CLs increased significantly (t = 4.238, P < 0.01) during hypermetabolic phase.

CONCLUSIONS

There are great differences in propofol pharmacokinetics between shock phase and hypermetabolic phase in severely burned rabbits. The change is characterized by increase in Vc and AUC, extension of t1/2alpha and t1/2beta, decrease in CLs during shock phase and obvious increase of CLs during hypermetabolic phase.

摘要

目的

探讨兔重度烧伤休克期和高代谢期丙泊酚的药代动力学特征及差异。

方法

将20只新西兰兔按随机数字表法分为烧伤组(n = 10)和假伤组(n = 10)。烧伤组兔给予30%TBSA全层烫伤(以下简称烧伤),立即进行复苏,并于伤后6小时静脉注射丙泊酚5.1 mg/kg。分别于注射后1、3、5、10、15、20、30、45、60、90分钟从左颈外静脉采集血液1.5 mL。1周后重复上述操作。假伤组兔处理方法同烧伤组,但为假烫伤。采用高效液相色谱法测定血浆中丙泊酚浓度。用3P97实用药代动力学计算程序分析丙泊酚浓度-时间数据,然后选择最适合的房室模型计算药代动力学参数。

结果

烧伤组丙泊酚血药浓度-时间曲线符合二室模型,假伤组符合三室模型。在休克期,与假伤组兔的中央室分布容积[Vc,(3.1±1.5)L/kg]、曲线下面积[AUC,(25±7)mg·min·L⁻¹]、消除相半衰期[t1/2β,(113±93)min]、清除率[CLs,(110±50)mL·kg⁻¹·min⁻¹]相比,烧伤组兔的Vc[(8.8±4.2)L·kg⁻¹]和AUC[(44±10)mg·min·L⁻¹]显著升高(t值分别为3.191和3.668,P值均<0.01);t1/2β[(339±258)min]延长(t = 2.932,P < 0.05);CLs[(40±30)mL·kg⁻¹·min⁻¹]降低(t = -3.013,P < 0.05)。在高代谢期,烧伤组兔的CLs[(180±40)mL·kg⁻¹·min⁻¹]显著高于假伤组[(90±30)mL·kg⁻¹·min⁻¹,t = -3.013,P < 0.05]。与烧伤组兔休克期相比,高代谢期兔的Vc[(4.1±1.3)L/g]和AUC[(

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