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目的 探讨慢性肾衰患者和正常对照组空腹口服开同后支链酮酸的代射动力学的变化。方法 采用气相色谱-质谱联用仪测定血浆支链酮酸的浓度。结果 慢性肾衰患者空腹血浆亮氨酸酮酸和异亮氨酸酮酸的浓度低于正常对照组(P<0.05),空腹口服开同后血浆亮氨酸酮酸、异亮氨酸酮酸和缬氨酸酮酸的最高峰浓度分别为(67.7±12.9)、(57.8±10.3)、(30.3±5.3)μmol/L;达峰浓度时间分别为(43.8±5.7)、(58.1±4.6)、(43.8±4.5)min;上述α-酮酸的消除半寿期T1/2分别(108.5±12)、(105±16.6)、(116.8±18)min。与对照组相比,肾衰组α-支链酮酸部分代谢动力学参数的差异无显著性。结论 慢性肾衰患者胃肠道对开同中α-支链酮酸的吸收功能正常,提示通过口服支链酮酸制剂纠正慢性肾衰患者的血浆支链酮酸水平是可行的。
Objective To investigate the changes of the pharmacokinetics of branched-chain ketoacid after oral administration of fasting in patients with chronic renal failure and normal control group. Methods The concentrations of branched-chain ketoacid in plasma were determined by gas chromatography-mass spectrometry. Results The levels of fasting plasma leucyl keto acid and isoleucine ketoacid in patients with chronic renal failure were lower than those in the normal control group (P <0.05). After fasting and oral administration, leucine keto acid and isoleucine keto acid And valine ketoacid were (67.7 ± 12.9), (57.8 ± 10.3) and (30.3 ± 5.3) μmol / L, respectively; the time to peak concentration were (43.8 ± 5.7) and (58.1 ± 4.6) , (43.8 ± 4.5) min, respectively. The elimination half-life of these α-keto acids was (108.5 ± 12), (105 ± 16.6) and (116.8 ± 18) min, respectively. Compared with the control group, there was no significant difference in some pharmacokinetic parameters of alpha-branched-chain ketoacid in renal failure group. Conclusion The gastrointestinal tract of patients with chronic renal failure has normal absorption of a-branched-chain ketoacid in the same kidney, suggesting that it is feasible to correct the plasma levels of branched-chain ketoacid in patients with chronic renal failure through oral administration of branched-chain ketoacid preparations.