Philip-Joet F, Bruguerolle B, Arnaud C, Arnaud A
Respiration. 1987;51(1):68-72. doi: 10.1159/000195167.
The purpose of this study was to determine the relationship between inflammation, increased alpha-1-acid glycoprotein (AAG), and lidocaine tolerance during fiber-optic bronchoscopy. Previous studies indicate that serum lidocaine levels vary widely from one individual to another. One reason for these variations may be the presence of an ongoing inflammatory process, which enhances serum AAG, a major binding protein of lidocaine. To test this hypothesis, we assayed free and bound lidocaine as well as AAG in the blood of 12 patients after administration of 9 mg/kg of lidocaine during fiber-optic bronchoscopy. Some of the subjects had clear evidence of inflammation or infection. A correlation was found between AAG and total and bound lidocaine but not between AAG and free lidocaine (which remained almost constant). Thus, in spite of the high total levels of lidocaine observed in some patients with inflammatory processes, the free fraction (which is the active and toxic fraction) remained low.
本研究的目的是确定炎症、α-1-酸性糖蛋白（AAG）升高与纤维支气管镜检查期间利多卡因耐受性之间的关系。先前的研究表明，血清利多卡因水平在个体之间差异很大。这些差异的一个原因可能是存在持续的炎症过程，这会增加血清AAG，AAG是利多卡因的主要结合蛋白。为了验证这一假设，我们在12例患者纤维支气管镜检查期间给予9mg/kg利多卡因后，测定了其血液中游离和结合的利多卡因以及AAG。部分受试者有明确的炎症或感染证据。结果发现AAG与总利多卡因及结合利多卡因之间存在相关性，但AAG与游离利多卡因之间不存在相关性（游离利多卡因几乎保持恒定）。因此，尽管在一些有炎症过程的患者中观察到利多卡因的总水平较高，但其游离部分（即活性和毒性部分）仍然较低。
