托拉塞米治疗儿童急性心力衰竭患者的药代动力学和药效学
Research of the Pharmacokinetics and Pharmacodynamics of Torasemide in the Treatment of Children Patients with Acute Heart Failure
-
摘要: 目的 探讨托拉塞米治疗儿童急性心力衰竭患者的药代动力学和药效学特点.方法 选取90例儿童急性心力衰竭患者将其随机分为3组, 分别给予不同静脉治疗剂量的托拉塞米, 在一次性用药后, 采用液相色谱-串联质谱法测定血药浓度, 分析药代动力学和药效学参数, 为临床合理用药提供依据.结果 各组的平均药代动力学参数除达峰浓度Cmax, 药时曲线下面积AUC0-16有差别外 (P<0.01) , 其余药代动力学参数均无显著差异 (P>0.05) ;试验组Ⅱ和试验组Ⅲ患者的24 h总尿量明显高于试验组Ⅰ的患者, 差异有统计学意义 (P<0.01) , 而试验组Ⅱ与试验组Ⅲ的24 h总尿量差异无统计学意义 (P>0.05) ;3个剂量组药后血压、体重、腹围、血钾、钠、氯较药前均无显著变化, 组间比较亦差异无统计学意义 (P>0.05) .结论 儿童急性心力衰竭患者对托拉塞米耐受性良好, 结合药代动力学及药效学特点分析, 托拉塞米治疗儿童急性心力衰竭患者的推荐剂量为1.0mg/ (kg.d) .Abstract: Objective To investigate the pharmacokinetics and pharmacokinetics of torsemide in children with acute heart failure.Me thods Ninety cases of children with acute heart failure patients were randomly divided into three groups which were given different intravenous therapy doses of torsemide. Our goal is to provide the basis for clinical rational therapy by analyzing parameter of the pharmacokinetics and pharmacokinetics of torsemide which is acquired by detecting plasma concentration of torsemide with liquid chromatography and tandem mass spectrometry after a one-time medication. Re s ult Average pharmacokinetic parameters of the three groups in addition to the peak concentration (Cmax) and medication in the area under the curve (AUC0-16) are different (P < 0.01) , the rest of the pharmacokinetic parameters had no significant difference (P > 0.05) . The 24 hours urine volume of the experimental group Ⅱ and the experimental group Ⅲ were obviously higher than that of the experimental group Ⅰ, so the difference was statistically significant (P < 0.01) .The 24 hours urine volumes between the experimental group Ⅱ and the experimental group Ⅲ were no significant difference (P > 0.05) .There was no significant change in blood pressure, weight, abdominal girth, blood potassium, blood sodium and blood chlorine in the three dose groups compared with those before the treatment.There was no significant difference between the three groups (P>0.05) .Conclus ionThe children with acute heart failure were well tolerated with torsemide.The recommended dose of torsemide is 1.0 mg/ (kg.d) in the treatment of acute heart failure in children, based on pharmacokinetic and pharmacodynamic characteristics.
-
Key words:
- Acute heart failure /
- Torasemide /
- Blood concentration /
- Children /
- Pharmacokinetics /
-
[1]李燕萍, 郝应禄, 陈利, 等.射血分数保留的心力衰竭临床特征[J].昆明医科大学学报, 2016, 37 (4) :107-111. [2]彭妍钰, 潘蓉蓉.托拉塞米治疗充血性心力衰竭的安全性及对心功能的影响[J].中国医药导报, 2011, 8 (15) :78-79. [3]钟飞, 李伟, 许先进.31例托拉塞米注射剂治疗急性左心衰竭的临床分析[J].中国民康医学, 2012, 24 (13) :1537-1538. [4]刘世秀.托拉塞米治疗心力衰竭的临床效果分析[J].现代诊断与治疗, 2014, 25 (19) :4436-4437. [5]宋菲, 张冬颖, 刘剑.利尿剂在心力衰竭中的治疗进展[J].医学综述, 2015, 21 (8) :1427-1429. [6]肖群文, 杨龙, 李琪, 等.托拉塞米治疗儿童急性心力衰竭的药动学和药效学研究进展[J].医学综述, 2017, 23 (11) :2236-2244. [7] 胡亚美, 江载芳.诸福棠实用儿科学[M].第7版.北京:人民卫生出版社, 2006:1510-1525. [8] [8] SCHWARTZ S, BRATER D C, PPIMD D, et al.Bioavailability, pharmacokinetics and pharmacodynamics of torasemide in patients with cirrhosis[J].Clin Pharmacol Ther, 1993, 54 (1) :90-97. [9]黄浙勇, 钱菊英, 葛均波.心力衰竭治疗中袢利尿剂的合理应用[J].中国临床医学, 2011, 18 (6) :897-898. [10]刘文德.托拉塞米注射液治疗急性左心衰竭患者疗效观察[J].黑龙江医药, 2016, 29 (2) :274-276. [11] [11] ACHHAMMER I, METZ P.Low dose loop diuretics in essential hypertension:experience with torasemide[J].Drugs, 1991, 41 (3) :80-91. [12]龙岩, 周宗华, 周承操.托拉塞米与呋塞米对慢性心力衰竭治疗效果的比较[J].中国医药科学, 2015, 5 (9) :85-87. -
点击查看大图
计量
- 文章访问数: 2095
- HTML全文浏览量: 719
- PDF下载量: 76
- 被引次数: 0
下载:
