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[顺铂肾脏重吸收的药代动力学证据]

[Pharmacokinetic evidence for the renal reabsorption of CDDP].

作者信息

Kurose T, Sasaki T, Mochizuki M, Yasuda M, Yamazaki T, Sasagawa M, Tanaka K, Hando T

出版信息

Nihon Gan Chiryo Gakkai Shi. 1989 Jun 20;24(6):1229-37.

PMID:2794646
Abstract

CDDP has had a wide use and a remarkable progress in cancer chemotherapy. Among others nephrotoxicity is the principal dose-limiting factor in this drug. So that the pharmacokinetics of CDDP mainly for the kidney was investigated in 4 patients with gynecological malignancies. CDDP was administered by short-term (about 45 minutes) intra-arterial infusion at a dose of 100 mg/body. Total CDDP (T) and non-protein-bound CDDP (NPB) concentrations in plasma declined in a biphasic manner, with a half life values of 0.506, 0.551 hr in alpha phase and 102, 96 hr in beta phase respectively. Protein-bound plasma CDDP (PB) in the time concentration curve showed two peaks, at the end of infusion and at about 3-5 hours after infusion to be followed by biphasic declining, which showed similarity to the simulation curve supposing the delayed influx. Total urinary excretion rate (up to 48 hours after infusion) was 15% on the average. It was shown that there was a close relation between urinary volume of less than 3 ml/min and NPB clearance (R = 0.877). And then there was a significant difference of NPB clearances by the kidney between cases of less than 200 ng/ml of NPB plasma concentration and those over 200 ng/ml. Binding proteins at the first and the second peak were analyzed by gel filtration method. At the second peak PB was mostly detected on the albumin fraction, which was different from the first peak. The mean estimated renal reabsorption of CDDP after 3 hours following injection was about 2 mg. (ABSTRACT TRUNCATED AT 250 WORDS)

摘要

顺铂在癌症化疗中已得到广泛应用且取得了显著进展。其中,肾毒性是该药物的主要剂量限制因素。因此,对4例妇科恶性肿瘤患者研究了主要针对肾脏的顺铂药代动力学。顺铂通过短期(约45分钟)动脉内输注给药,剂量为100mg/体。血浆中总顺铂(T)和非蛋白结合顺铂(NPB)浓度呈双相下降,α相半衰期值分别为0.506、0.551小时,β相半衰期值分别为102、96小时。血浆中蛋白结合顺铂(PB)的时间浓度曲线显示有两个峰值,分别在输注结束时和输注后约3 - 5小时,随后呈双相下降,这与假设延迟流入的模拟曲线相似。输注后48小时内的总尿排泄率平均为15%。结果表明,尿量小于3ml/分钟与NPB清除率之间存在密切关系(R = 0.877)。然后,血浆NPB浓度低于200ng/ml的病例与高于200ng/ml的病例相比,肾脏对NPB的清除率存在显著差异。通过凝胶过滤法分析了第一和第二峰值处的结合蛋白。在第二峰值处,PB大多在白蛋白组分中检测到,这与第一峰值不同。注射后3小时顺铂的平均估计肾脏重吸收约为2mg。(摘要截短至250字)

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