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作者不同意Knapp等[见本刊11(5):257,1984]的意见。Knapp等认为甲腈咪胍对滴注利多卡因的病人可使其血清利多卡因浓度上升75％,因而利多卡因中毒发生率增加;并认为甲腈咪胍降低肝血流,导致利多卡因的清除减少。作者认为滴注时血清利多卡因浓度上升,是由于血浆内游离的及总的利多卡因清除减少,因而使游离的及总的药量分别升高15％及50％。游离利多卡因浓度改变的机制未明,但总量改变是由于心肌梗塞病人血浆中利多卡因的主要结合蛋白即α_1-酸性糖蛋白增加所致。Knapp等未分别测定血浆内游离与总的利
The author disagrees with the opinion of Knapp et al [see 11 (5): 257, 1984]. Knapp so that nitidoguanidine infusion of lidocaine in patients with lidocaine serum levadocaine concentration increased by 75%, thus increasing the incidence of lidocaine poisoning; and that nitmidimidine reduces hepatic blood flow, leading to lidoca Elimination due to reduced. The authors suggest that elevated serum lidocaine concentrations at the time of instillation were due to reduced free and total lidocaine clearance within the plasma, resulting in a 15% and 50% increase in free and total dose, respectively. The mechanism of the change of free lidocaine concentration is unknown, but the change of total amount is due to the increase of α 1-acidic glycoprotein which is the main binding protein of lidocaine in the plasma of patients with myocardial infarction. Knapp, etc. were not separately measured plasma free and total profit