性别对结核病患者顺式阿曲库铵药效学参数的影响

发布时间：2019-03-22 19:40

【摘要】：目的探讨性别对结核病患者顺式阿曲库铵药效学参数的影响。方法择期行全身麻醉手术80例,结核病(T组)及非结核病(N组)患者40例,两组依性别不同分为结核病男性组(TM组)、女性组(TF组)及非结核病男性组(NM组)、女性组(NF组),每组20例。所有患者入室后予静脉输注咪达唑仑0.1 mg/kg、芬太尼4μg/kg,靶控输注丙泊酚1~4μg/m L,患者意识消失后采用4个成串刺激进行肌松监测,静脉注射顺式阿曲库铵0.15 mg/kg,当第1个肌颤搐反应(T1)下降至最低值并连续重复3次以上时行气管插管,记录起效时间、T1最大抑制程度、临床作用时间、恢复指数、药理作用时间及气管插管条件和麻醉诱导前(t0)、给予肌松药后5 min(t1)、15 min(t2)、30 min(t3)、45 min(t4)、1 h(t5)时的平均动脉压和心率。结果与男性相比,T组女性起效时间较短,临床作用时间及药理作用时间较长(P0.01);与N组相比,T组患者顺式阿曲库铵临床作用时间及药理作用时间较短,但组间差异无统计学意义(P0.05)。结论结核病患者顺式阿曲库铵单次静脉注射时女性较男性更敏感,表现为起效时间较短,临床作用时间及药理作用时间较长。
[Abstract]:Objective to investigate the effect of sex on pharmacodynamic parameters of cis-atracurium in patients with tuberculosis. Methods 80 patients undergoing general anesthesia, 40 patients with tuberculosis (group T) and 40 patients with non-tuberculosis (group N), were divided into three groups according to sex: male tuberculosis group (TM group), female group (TF group) and non-tuberculosis male group (NM group). Female group (NF group), 20 cases in each group. All patients were given midazolam 0.1 mg/kg, fentanyl 4 渭 g / kg, target-controlled infusion of propofol (1 ~ 4 渭 g / mL) after entering the room. The patients' consciousness disappeared and muscle relaxation was monitored by four series of stimuli. Intravenous injection of cis-atracurium 0.15 mg/kg, was performed when the first twitch response (T1) was reduced to a minimum and repeated more than three times in a row. The onset time, the maximal inhibition degree of T1 and the clinical effect time were recorded. The mean arterial pressure and heart rate at 5 min (t _ 1), 15 min (t _ 2), 30 min (t _ 3), 45 min (t _ 4), 1 h (t _ 5) after muscle relaxant administration were measured. Results compared with male, the onset time of female in T group was shorter, the clinical effect time and pharmacological action time were longer (P0.01). Compared with N group, the clinical action time and pharmacological action time of T group were shorter than those of N group, but there was no significant difference between the two groups (P0.05). Conclusion single intravenous injection of cis-atracurium in patients with tuberculosis is more sensitive than that of men, showing shorter onset time, longer clinical action time and longer pharmacological action time.
【作者单位】：广东省深圳市第三人民医院麻醉科;
【基金】：广东省深圳市科技计划项目(医疗卫生类)一般项目(编号:201302097)
【分类号】：R614

【参考文献】