[1]孙国林,李生德,齐萍,等.婴幼儿体外循环期间氨甲环酸血液浓度研究[J].陆军军医大学学报(原第三军医大学学报),2013,35(01):69-72.
　Sun Guolin,Li Shengde,Qi Ping,et al.Study of plasma concentration of tranexamic acid during cardiopulmonary bypass in infants with tetralogy of Fallot[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(01):69-72.
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
35卷
期数:
2013年第01期
页码:
69-72
栏目:
论著
出版日期:
2013-01-15

文章信息/Info

Title:
Study of plasma concentration of tranexamic acid during cardiopulmonary bypass in infants with tetralogy of Fallot
作者:
孙国林; 李生德; 齐萍; 文仁国; 肖颖彬
第三军医大学新桥医院全军心血管外科研究所；青岛儿童医院麻醉科
Author(s):
Sun Guolin;  Li Shengde;  Qi Ping;  Wen Renguo;  Xiao Yingbin
Department of Cardiovascular Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037; Department of Anesthesia, Qingdao Children Hospital, Qingdao, Shandong Province, 266071, China
关键词:
氨甲环酸; 婴幼儿; 血药浓度; 磁共振波谱仪
Keywords:
tranexamic acid;  cardiopulmonary bypass;  infant;  1H-NMR
分类号:
R654.1; R726.54; R969.11
文献标志码:
A
摘要:
目的      研究婴幼儿法洛四联症（tetralogy of fallot,TOF）根治术体外循环(cardiopulmonary bypaass,CPB)期间应用氨甲环酸（tranexamic acid，TA）的血液浓度。      方法       5例先天性TOF患儿，体质量（7.36±2.08）kg，在开胸前应用TA 100 mg/kg，单次静脉缓慢注射（>10 min），CPB开始前再次注射100 mg/kg。应用磁共振波谱仪(1H-NMR)方法，检测不同时间段TA的血液浓度。      结果       CPB开始前(负荷剂量用药后约20 min)、CPB开始后1 h、手术结束时的血液TA浓度分别为（224.61±195.28）、（509.58±181.57）、（243.95±32.30）μg/mL。CPB开始前与CPB开始后1 h及手术结束时TA浓度比较均无统计学差异（P=0.052、0.83）；CPB开始后1 h与手术结束时TA浓度有统计学差异（P=0.02）。      结论      1H-NMR能够检测出TA的血液浓度。TA大于抑制有高度出血风险可能需要的血液浓度125 μg/mL时，提示可降低剂量。
Abstract:
Objective       To study the plasma concentration of tranexamic acid (TA) during cardiopulmonary bypass in infants with tetralogy of Fallot (TOF).       Methods        Five TOF infants with body weight of (7.36±2.08) kg were given an slow intravenous injection of initial dose of TA (100 mg/kg, >10 min) before thoracotomy, following by another 100 mg/kg TA before the initiation of cardiopulmonary bypass (CPB). The concentration of TA was measured in blood plasma using 1H-NMR spectroscopy.       Results      Plasma TA concentrations were (224.61±195.28) μg/mL before CPB (at 20 min after TA administration), (509.58±181.57) μg/mL at 60 min after CPB initiation, and (243.95±32.30) μg/mL at the end of operation, respectively. The plasma TA concentration before CPB was not significantly different from that at 60 min after CPB initiation (P=0.052) and that at the end of operation (P=0.83), but there was significant difference between plasma TA concentration at 60 min after CPB initiation and that at the end of operation (P=0.02).       Conclusion       A 100 mg/kg initial dose of TA followed by an infusion of 100 mg/kg before the initiation of CPB is sufficient enough to provide an effective plasma concentration, which is higher than 125 μg/mL for patients with high risk of bleeding, indicating the dose of TA can be decreased.

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更新日期/Last Update: 2012-12-31