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目的 比较紫绀及非紫绀型先天性心脏病(先心病)患儿罗库溴铵的药效学。方法 第一部分:选择非紫绀、轻度紫绀及重度紫绀型先心病患儿各12例,分别为非紫绀组、轻度紫绀组、重度紫绀组,测定0.6 mg／kg罗库溴铵的起效时间、作用时间及恢复指数。第二部分:40例先心病患儿,选择非紫绀、紫绀型先心病患儿各20例,分别为非紫绀组和紫绀组,每组患儿随机分为120、180、240、300μg／kg四个剂量组,用直线回归法建立罗库溴铵的量效曲线,计算罗库溴铵的ED50、ED90,及ED95。结果 第一部分:重度紫绀组起效时间较非紫绀组明显延长(P<0.05),三组间作用时间及恢复指数无差异。第二部分:紫绀组罗库溴铵的量效关系曲线较非紫绀组右移,紫绀组罗库溴铵ED50、ED90及ED95均较非紫绀组高(P<0.05)。结论 重度紫绀型先心病患儿罗库溴铵的起效时间延长,且对罗库溴铵的敏感性降低。
Objective To compare the pharmacodynamics of rocuronium in children with cyanotic and non-cyanotic congenital heart disease (congenital heart disease). Methods The first part: 12 cases of non-cyanotic, mild cyanotic and severe cyanotic congenital heart disease were selected, respectively, non-cyanotic group, mild cyanotic group, severe cyanotic group, the determination of 0.6 mg / kg rocuronium bromide onset Time, duration and recovery index. Part two: Forty children with CHD were enrolled in this study. Twenty children with non-cyanotic and cyanotic congenital heart disease were selected as non-cyanotic group and cyanotic group. The children in each group were randomly divided into 120,180,240 and 300 μg / kg Four dose groups, using linear regression method to establish the rocuronium dose-response curve, calculate rocuronium ED50, ED90, and ED95. Results The first part: The onset time of severe cyanosis group was significantly longer than that of non-cyanosis group (P <0.05). There was no difference between the three groups in the duration of action and recovery index. The second part: The dose-effect relationship curve of rocuronium in cyanotic group shifted to the right than that of non-cyanotic group. The ED50, ED90 and ED95 of rocuronium in cyanotic group were higher than those in non-cyanotic group (P <0.05). Conclusion The onset of onset of rocuronium in children with severe cyanotic congenital heart disease is prolonged and the sensitivity to rocuronium is reduced.