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[肥胖患者口服地塞米松的药代动力学]

[Pharmacokinetics of dexamethasone administered orally in obese patients].

作者信息

Lamiable D, Vistelle R, Sulmont V, Millart H, Caron J, Choisy H

机构信息

Laboratoire de Pharmacologie, CHRU Maison Blanche, Reims.

出版信息

Therapie. 1990 Jul-Aug;45(4):311-4.

PMID:2399513
Abstract

Dexamethasone pharmacokinetics was studied after oral administration of two Décadron tablets in six healthy controls and in eight obese patients whose weight was at least 20% above that of the ideal body weight. The absorption (0.30 +/- 0.09 h and 0.29 +/- 0.08 h) and elimination (4.52 +/- 0.57 h and 3.71 +/- 1.05 h) half-lives were not significantly different. Maximum plasma concentrations were similar (11.95 +/- 1.00 micrograms/l and 10.93 +/- 0.94 micrograms/l) but the lag-time was significantly higher in the obese patients (0.49 +/- 0.12 h and 0.13 +/- 0.04 h). A positive correlation was observed between the AUC and the total body weight (r = 0.738, p less than 0.01). Mean predexamethasone cortisol level was significantly lower in the obese patients (189.20 +/- 52.7 micrograms/l and 256.90 +/- 58 micrograms/l). The pharmacokinetics modifications were not sufficient to explain the increased false positive frequency in the dexamethasone suppression test of the hypothalamic-pituitary-adrenal axis in obesity.

摘要

在6名健康对照者和8名体重至少比理想体重高20%的肥胖患者中,口服两片地塞米松片后研究了地塞米松的药代动力学。吸收半衰期(分别为0.30±0.09小时和0.29±0.08小时)和消除半衰期(分别为4.52±0.57小时和3.71±1.05小时)无显著差异。最大血浆浓度相似(分别为11.95±1.00微克/升和10.93±0.94微克/升),但肥胖患者的滞后时间显著更长(分别为0.49±0.12小时和0.13±0.04小时)。观察到曲线下面积(AUC)与总体重之间呈正相关(r = 0.738,p < 0.01)。肥胖患者的地塞米松前皮质醇平均水平显著更低(分别为189.20±52.7微克/升和256.90±58微克/升)。药代动力学改变不足以解释肥胖患者下丘脑 - 垂体 - 肾上腺轴地塞米松抑制试验中假阳性频率增加的原因。

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