国际麻醉学与复苏杂志   2015, Issue (1): 2-2
    
不同性别癫痫患者维库溴铵剂量-反应曲线的测定
刘中杰, 徐世元1()
1.南方医科大学珠江医院
Investigating the dose-response curves of vecuronium in different gender epilepsy patients
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摘要:

目的 研究性别对癫痫患者维库溴铵量效关系的影响,为维库溴铵个体化应用提供参考。 方法 选取择期癫痫手术患者100例,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级,年龄19岁~41岁, 病史2年~23 年,分为男性组(M组)与女性组(F组),每组各50例,均有服用抗癫痫药物史,术前无酸碱平衡及水电解质紊乱,心、肺、肝、肾功能正常。每组患者按随机数字表法分为20、30、40、50、60 μg/kg 5个剂量组,每组10例。记录拇内收肌四个成串刺激(train of four stimulation, TOF) 第1次反应最大抑制的百分率并进行概率单位转换,将维库溴铵的首次剂量进行对数转换, 用直线回归方法分别建立男、女患者维库溴铵剂量-反应曲线,并记录起效时间。 结果 男性癫痫患者维库溴铵50%有效量(50% effective dose, ED50)、75%有效量(75% effective dose, ED75)、90%有效量(90% effective dose, ED90)、95%有效量(95% effective dose, ED95)值分别为(31±6)、(40±8)、(50±9)、(57±7) μg/kg,女性癫痫患者维库溴铵ED50、ED75、ED90、ED95值分别为(31±6)、(40±7)、(50±9)、(58±9) μg/kg,两者间差异无统计学意义(P>0.05);5个剂量组起效时间在性别组间比较,差异无统计学意义(P>0.05)。 结论 性别不影响癫痫患者维库溴铵的剂量?蛳反应曲线。

关键词: 性别因素; 癫痫; 肌肉松弛药; 维库溴铵; 药效动力学; 剂量-反应曲线
Abstract:

Objective To evaluate the gender differences in dose-response curve of vecuronium in epilepsy patients and provide a reference for its individualized application. Methods Hundred ASA grade Ⅰ-Ⅱ epilepsy patients were enrolled in this study. All patients were divided into male group(group M) and female group(group F)(n=50), they recieved the method of single dose injection under midazolam-fentanyl intravenous anesthesia. Every patient received intravenous single bolus of 20, 30, 40, 50, 60 μg/kg of vecuronium respectively(n=10). The neuromuscular block was measured by neuromuscular transmission monitor and the responses were defined in terms of the percentages of maximum suppression in T1 of train of four stimulation(TOF) of the adductor pollicis muscle. According to log-probit transformation of the data of dose and response, the dose-response curve of vecuronium was established through linear regression. The onset time of vecuronium was also observed. Results The 50% effective dose(ED50),75% effective dose(ED75), 90% effective dose(ED90), 95% effective dose(ED95) values of vecuronium in male epilepsy patients were(31±6),(40±8),(50±9),(57±7) μg/kg. The ED50, ED75, ED90, ED95 values of vecuronium in female epilepsy patients were(31±6),(40±7),(50±9),(58±9) μg/kg. No significant difference in onset time was observed among 5 dose groups(P>0.05). Conclusions There was no gender difference in dose-response curve of vecuronium in epilepsy patients.

Key words: Sex factors; Epilepsy; Muscle relaxants; Vecuronium; Pharmacodynamics; Dose-response curve