老年急性病患者的α1-酸性糖蛋白浓度及普萘洛尔结合情况
Alpha 1-acid glycoprotein concentrations and propranolol binding in elderly patients with acute illness.
作者信息
Paxton J W, Briant R H
出版信息
Br J Clin Pharmacol. 1984 Nov;18(5):806-10. doi: 10.1111/j.1365-2125.1984.tb02548.x.
Alpha 1-acid glycoprotein (AAG) concentrations and propranolol binding were investigated in the serum of elderly hospitalized patients with acute illness, and healthy elderly and young subjects. Significantly greater AAG concentrations and reduced unbound propranolol fraction were observed in the elderly with acute disease compared to the elderly controls. The greatest changes (up to five-fold) occurred with cancer, with lesser changes associated with myocardial infarction and ischaemic heart disease, acute infection, heart failure, chronic obstructive respiratory disease, and cerebrovascular accident. Various miscellaneous conditions were also associated with high AAG concentrations and enhanced propranolol binding. The healthy elderly had higher AAG concentrations and lower unbound propranolol fractions than the healthy young group. Overall there was a highly significant correlation between the propranolol binding ratio (bound/free) and the serum AAG concentration. These results suggest that the elderly population may be particularly susceptible to changes in AAG concentrations, and that during acute illness interpretation of serum concentrations of drugs which bind mainly to AAG, may require knowledge of their free fractions.
对老年急性病住院患者以及健康老年人和年轻人的血清中的α1-酸性糖蛋白（AAG）浓度和普萘洛尔结合情况进行了研究。与老年对照组相比，急性病老年人的AAG浓度显著更高，未结合的普萘洛尔分数降低。癌症患者的变化最大（高达五倍），心肌梗死和缺血性心脏病、急性感染、心力衰竭、慢性阻塞性呼吸道疾病和脑血管意外患者的变化较小。各种杂症也与高AAG浓度和增强的普萘洛尔结合有关。健康老年人的AAG浓度高于健康年轻人组，未结合的普萘洛尔分数低于健康年轻人组。总体而言，普萘洛尔结合率（结合/游离）与血清AAG浓度之间存在高度显著的相关性。这些结果表明，老年人群可能对AAG浓度的变化特别敏感，并且在急性病期间，对主要与AAG结合的药物的血清浓度进行解释时，可能需要了解其游离分数。
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