新型肌松拮抗药舒更葡糖的研究进展

发布时间：2018-06-25 00:25

本文选题：舒更葡糖 + 肌松拮抗　；参考：《中国药房》2017年05期

【摘要】：目的:了解舒更葡糖(Sugammadex)的研究进展。方法:查阅近年来国内外相关文献,就舒更葡糖的作用机制、药动学特点、临床应用、特殊人群应用和不良反应的研究进行归纳和总结。结果与结论:舒更葡糖通过与氨基甾体类肌松药在血浆中特异性地紧密结合成稳定螯合物的方式降低血浆肌松药浓度,使神经肌肉接头处肌松药不断顺浓度差转运至血浆,再通过肾脏排出体外,最终达到拮抗肌松的作用。目前的研究推荐舒更葡糖用于改善罗库溴铵(ROC)的严重过敏反应,帮助解决无法插管通气的临床问题,以及快速、安全、有效地逆转健康成人的ROC和维库溴铵不同程度的神经肌肉阻滞。舒更葡糖在特殊人群的应用方面,暂支持其用于2~18岁儿童、老年人、肥胖者及心、肺、肝、肾(除肾衰竭)、神经肌肉功能障碍患者,但缺乏大量的临床研究数据和循证医学证据。舒更葡糖在2岁以下患儿、孕妇和哺乳期妇女等的临床研究较少。舒更葡糖具有较好的耐受性和安全性,但临床应警惕其潜在的严重过敏反应、QTc间期延长、出血风险增加和神经毒性等。
[Abstract]:Objective: to investigate the research progress of Sugammadex. Methods: the research on the mechanism, pharmacokinetics, clinical application, application of special population and adverse reactions of Sugeng-glucosamine were summarized and summarized by referring to the related literatures at home and abroad in recent years. Results and conclusion: Sugeng-glucosamine can reduce plasma concentration of muscle relaxants by specifically combining with aminosteroidal muscle relaxants to form stable chelates in plasma, so that muscle relaxants at neuromuscular junctions can be transported to plasma continuously by cis-concentration difference. Then the kidney was excreted from the body, and finally the antagonistic effect of muscle relaxation was achieved. Current studies recommend that Sugarin glucosaccharide be used to improve severe allergic reactions to rocuronium (ROC), to help solve clinical problems that cannot be ventilated with intubation, and to be quick and safe. Effective reversal of ROC and vecuronium neuromuscular block in healthy adults. The application of Sugeng-glucosamine in special populations is temporarily supported by its use in children aged 2 to 18, elderly, obese, and patients with heart, lung, liver, kidney (excluding renal failure), neuromuscular dysfunction, However, there is a lack of large amounts of clinical data and evidence-based medical evidence. There are fewer clinical studies of suganin in children under 2 years of age, pregnant and lactating women. Sugeng-glucosamine has good tolerance and safety, but clinical attention should be paid to the prolongation of QTc interval, increased risk of bleeding and neurotoxicity.
【作者单位】：重庆医科大学附属儿童医院麻醉科;
【基金】：国家临床重点专科建设项目
【分类号】：R971

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