Decreased quinidine plasma protein binding during hemodialysis
Decreased quinidine plasma protein binding during hemodialysis
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血液透析期间奎尼丁血浆蛋白结合减少
DOI：
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发表时间：
1981
期刊：
影响因子：
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通讯作者：
G. Perez
中科院分区：
文献类型：
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作者：
K. Kessler;G. Perez
在基线条件下和单次血液透析期间肝素后，对10例定期透析的终末期肾病患者的奎尼丁与血清蛋白的结合进行定量。加入2 μg/ml硫酸奎尼丁后，通过超滤结合荧光分光光度法在体外测定奎尼丁结合。在我们的患者中，基线未结合奎尼丁浓度百分比为6.5 ± 2.3%（平均值± SD），该值低于正常受试者（9.9 ± 3.0%，n = 18，p < 0.005）。结合与血清白蛋白（r = 0.72，p < 0.02）和游离脂肪酸（r = 0.65，p < 0.05）浓度相关。肝素治疗后，每例受试者的游离奎尼丁百分比（12.2 ± 5.6%，p < 0.025）和游离脂肪酸浓度（1111 ± 1202 μEq/1，p = 0.004）均升高。肝素后，奎尼丁结合和游离脂肪酸浓度之间的关系再次明显（r = 0.97，p < 0.001）。血液透析期间游离奎尼丁以及其他药物水平的动态变化可能需要调整，以避免毒性和不良相互作用。
Quinidine binding to serum proteins was quantitated in 10 regularly dialyzed patients with end‐stage renal disease, both under baseline conditions and after heparin during a single hemodialysis. Quinidine binding was determined in vitro, after the addition of 2 μg/ml quinidine sulfate, by ultrafiltration combined with spectrophotofluorometry. The baseline percent unbound quinidine concentration in our patients was 6.5 ± 2.3% (mean ± SD), a value lower than in normal subjects (9.9 ± 3.0%, n = 18, p < 0.005). Binding correlated with both serum albumin (r = 0.72, p < 0.02) and free fatty acid (r = 0.65, p < 0.05) concentrations. After heparin there was a rise in percent unbound quinidine (12.2 ± 5.6%, p < 0.025) and in free fatty acid concentration (1111 ± 1202 μEq/1, p = 0.004) in each subject. After heparin the relationship between quinidine binding and free fatty acid concentration was again evident (r = 0.97, p < 0.001). Dynamic changes in the levels of free quinidine, as well as other drugs during hemodialysis, may require adjustments to avoid toxicity and adverse interactions.