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在肾衰病人常常发现药物与蛋白结合减少,(?)往的文献报告表明这种改变主要见于酸性药物,例如肾衰时硫喷妥钠游离分数明显增加。肾衰时碱性药物与血浆蛋白结合的变化较大。阿芬太尼系弱碱性药物,92%与血浆蛋白结合,特别是α_1糖蛋白。是否肾衰时对阿芬太尼与蛋白结合和药动学有影响尚未肯定。本文作者选择19名病人,观察肾衰对阿芬太尼药动学及与蛋白结合情况的影响。肾衰组(n=9)年龄43±13岁,体重61±6 kg,2例因少尿长期行血液透析,7例处于透析前期,肌酐清除率<10m1/min。对照组(n=10)年龄45±13岁,体重59±14kg。全部病人肝功均正常。术前药均口
In renal failure patients often find that drug and protein binding decreased, (?) To the literature report shows that this change is mainly seen in acidic drugs, such as renal failure, thiopental sodium free fraction increased significantly. Kidney failure alkaline drugs and plasma protein binding changes. Alfentanil is a weakly basic drug, 92% bound to plasma proteins, especially the alpha 1 glycoprotein. Whether renal failure affects the combination and pharmacokinetics of alfentanil has not yet been confirmed. The authors selected 19 patients to observe the effects of renal failure on the pharmacokinetics and protein binding of alfentanil. Renal failure group (n = 9) was 43 ± 13 years old with a body weight of 61 ± 6 kg. Two patients underwent hemodialysis due to oliguria in the long term. Seven patients were in pre-dialysis and the creatinine clearance rate was less than 10m1 / min. The control group (n = 10) was 45 ± 13 years old and weighed 59 ± 14 kg. All patients with normal liver function. Preoperative drugs are mouth