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肝切除术和血浆胆碱酯酶抑制对猪体内可卡因代谢及心血管反应的影响。

The effect of hepatectomy and plasma cholinesterase inhibition on cocaine metabolism and cardiovascular responses in pigs.

作者信息

Kambam J R, Franks J J, Mets B, Janicki P K, Hickman R, van der Watt M

机构信息

Department of Anesthesiology, Vanderbilt University Hospital, Nashville, TN 37232-2125.

出版信息

J Lab Clin Med. 1994 Nov;124(5):715-22.

PMID:7964130
Abstract

To determine the effects of total hepatectomy and inhibition of plasma cholinesterase activity on cocaine metabolism, we measured plasma concentrations of cocaine and its three major metabolites, benzoylecgonine, ecgonine methyl ester, and norcocaine, by high-performance liquid chromatography in three groups of male pigs. Pigs were anesthetized with sodium thiopental and lungs were ventilated with nitrous oxide in oxygen. A right carotid arterial cannula and an internal jugular venous catheter were then inserted for the administration of cocaine and for blood sampling. A Swan-Ganz catheter was inserted through the right internal jugular vein. Group 1 pigs underwent sham operation; group 2 and 3 pigs underwent hepatectomy and portocaval shunt. In addition, group 3 pigs were treated with tetraisopropyl pyrophosphoramide, a specific plasma cholinesterase inhibitor. After this preparation, pigs were given 4 mg/kg cocaine intravenously over 2 minutes. After cocaine injection, 4 ml blood was collected into heparinized test tubes containing 2.5% sodium fluoride for determination of cocaine and its metabolites at 2, 5, 10, 15, 30, 45, 60, 90, 120, 180, 240, and 300 minutes. We also measured hemodynamic responses after cocaine administration, including heart rate and rhythm, cardiac output, and arterial blood pressure. Data were analyzed by analysis of variance. Blood levels of cocaine and its metabolites were significantly different among the three groups (p < 0.05 by analysis of variance). Our results show that total hepatectomy was associated with a marked slowing of cocaine metabolism, absence of norcocaine, and increased benzoylecgonine levels when compared with the baseline values in the control pigs.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了确定全肝切除和抑制血浆胆碱酯酶活性对可卡因代谢的影响,我们通过高效液相色谱法测量了三组雄性猪血浆中可卡因及其三种主要代谢物苯甲酰爱康宁、爱康宁甲酯和去甲可卡因的浓度。猪用硫喷妥钠麻醉,肺部用氧化亚氮和氧气通气。然后插入右颈总动脉插管和颈内静脉导管用于注射可卡因和采血。通过右颈内静脉插入一根 Swan - Ganz 导管。第 1 组猪接受假手术;第 2 组和第 3 组猪接受肝切除和门腔静脉分流术。此外,第 3 组猪用四异丙基焦磷酸酰胺治疗,这是一种特异性血浆胆碱酯酶抑制剂。在此准备之后,猪在 2 分钟内静脉注射 4mg/kg 可卡因。注射可卡因后,将 4ml 血液收集到含有 2.5%氟化钠的肝素化试管中,用于在 2、5、10、15、30、45、60、90、120、180、240 和 300 分钟时测定可卡因及其代谢物。我们还测量了可卡因给药后的血流动力学反应,包括心率和心律、心输出量和动脉血压。数据通过方差分析进行分析。三组之间可卡因及其代谢物的血药浓度有显著差异(方差分析 p < 0.05)。我们的结果表明,与对照猪的基线值相比,全肝切除与可卡因代谢显著减慢、去甲可卡因缺失以及苯甲酰爱康宁水平升高有关。(摘要截断于 250 字)

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