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目的 :应用群体药理学方法探讨血浆中乙醇浓度对 β 羟丁酸 ,乙酰乙酸 ,乳酸 ,丙酮酸 ,β 羟丁酸 乙酰乙酸 (H A)比值及乳酸 丙酮酸 (L P)比值变化的效应。方法 :给 14名健康成人口服剂量相当于1.0 2g·L-1总身体水的乙醇。在另一项实验中 ,给 8名健康成人静脉注射剂量相当于 0 .83g·L-1总身体水的乙醇。在服用乙醇后 380min采取静脉血测定乙醇 ,β 羟丁酸 ,乙酰乙酸 ,乳酸及丙酮酸的血浆浓度。在静注乙醇后 340min采血测定上述 5种物质的血浆浓度。结果 :在口服乙醇实验中 ,C0 为 6 6 .6±8.1mg·dl-1,显著低于 10 2mg·dl-1,(t检验 ,P <0 .0 0 1)。清除相斜率 β为 0 .2 2 9± 0 .0 5mg·dl-1·min-1。在静注实验中 ,C0 为 75 .6± 10 .9mg·dl-1,与 83mg·dl-1比较无显著性差异 ,β为0 .2 4 5± 0 .0 5mg·dl-1·min-1。在两项实验中 ,我们应用群体间接生理反应模型来拟合乙醇浓度对 β 羟丁酸 ,乙酰乙酸 ,乳酸 ,丙酮酸 ,β 羟丁酸 乙酰乙酸比值及乳酸 丙酮酸比值变化的效应 ,并得出各项参数。同时 ,我们发现 ,当乙醇的清除相结束时 ,H A比值尚未达最大值 ,说明在乙醇的零级代谢相时肝脏仍在产生NADH。乳酸和乙醇的关系曲线显示乳酸的变化呈现一种逆时钟方向的滞后。结论 :血L P比值不适合用作实
OBJECTIVE: To evaluate the effect of ethanol concentration on the ratio of β-hydroxybutyrate, acetoacetate, lactate, pyruvate, acetoacetate (H A) and lactate pyruvate (L P) in human plasma. Methods: A total of 14 healthy adults were dosed with ethanol equivalent to 1.02 g · L -1 total body water. In another experiment, eight healthy adults were given intravenous doses of ethanol equivalent to 0.83 g · L -1 total body water. Venous blood was taken at 380 min after taking ethanol to determine plasma concentrations of ethanol, beta-hydroxybutyrate, acetoacetate, lactate and pyruvate. Blood plasma was collected at 340 min after intravenous infusion of ethanol to determine the above five substances. RESULTS: In oral ethanol experiments, C0 was 66.6 ± 8.1 mg · dl-1, significantly lower than 102 mg · dl-1 (t test, P <0.001). Clear phase slope β was 0.229 ± 0. 05mg · dl-1 · min-1. In the intravenous injection experiment, C0 was 75.6 ± 10.9 mg · dl-1, no significant difference compared with 83mg · dl-1, β was 0.245 ± 0. 05mg · dl-1 · min -1. In both experiments, we used a population-based indirect physiological response model to fit the effect of ethanol concentration on changes in beta hydroxybutyrate, acetoacetate, lactate, pyruvate, beta-hydroxybutyrate acetoacetate ratio, and lactate pyruvate ratio Out of the parameters. At the same time, we found that the HA ratio has not yet reached the maximum when the phase of ethanol removal is completed, indicating that the liver is still producing NADH at the zero-order metabolic phase of ethanol. Lactic acid and ethanol showed that the changes in lactic acid showed a reverse clock direction hysteresis. Conclusion: The blood L P ratio is not suitable for use as a real