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目的研究丙泊酚靶控输注用于国人老年患者的群体药代动力学。方法32例择期下腹部开腹手术的患者,ASAⅠ-Ⅱ级,年龄65～82岁的老年患者,采用靶控输注方式(以血浆浓度为靶)输注丙泊酚,丙泊酚血浆浓度为3μg·mL-1。术中取桡动脉血,以反向高效液相色谱—荧光法测定丙泊酚的血浆浓度。用NONMEM软件分析丙泊酚的药代动力学参数。结果国人老年患者靶控输注丙泊酚的药代动力学过程符合三室开放模型,年龄、瘦体重对中央室清除率有影响,性别对第三分布容积有影响。结论年龄、瘦体重、性别对国人老年患者丙泊酚的药代动力学参数有影响。群体药代动力学参数应用于个体时,应根据个体情况相应调整靶控输注的药代动力学参数,以改善靶控输注系统的精确性。
Objective To study the population pharmacokinetics of target propofol infusion in Chinese elderly patients. Methods Thirty-two patients undergoing open lower abdominal surgery, ASAⅠ-Ⅱ and elderly patients aged 65-82 years were enrolled in this study. Target-controlled infusion of propofol and propofol at a plasma concentration of 3μg · mL-1. During operation, radial arterial blood was taken and plasma concentrations of propofol were determined by reverse-phase high performance liquid chromatography-fluorescence spectrometry. Pharmacokinetic parameters of propofol were analyzed using NONMEM software. Results The pharmacokinetics of target-controlled infusion of propofol in Chinese elderly patients were in accordance with the three-compartment open model. Age and lean body mass affected the clearance rate of the central ventricle. Gender had an impact on the volume of the third volume. Conclusion Age, lean body mass and gender influence the pharmacokinetic parameters of propofol in elderly patients. When population pharmacokinetic parameters are applied to an individual, the pharmacokinetic parameters of the target controlled infusion should be adjusted accordingly to improve the accuracy of the target controlled infusion system.