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
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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.
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Key words:
- Acute heart failure /
- Torasemide /
- Blood concentration /
- Children /
- Pharmacokinetics /
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