中国健康人群口服米格列奈钙片的群体药动学研究

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目的:通过建立米格列奈在健康人群体内群体药动学模型(PPK),探究米格列奈在中国健康人体内的药动学特点,评价米格列奈的临床药动学影响因素.方法:收集22名健康受试者的临床资料,进行单剂量给药试验,受试者口服米格列奈钙片10 mg后,利用LC-MS/MS法测定米格列奈血药浓度,用非线性混合效应模型(NONMEM)程序中的条件一级评估算法(FOCE)对数据进行分析,定量评价人口统计学指标、生化指标等固定效应因素对药动学参数的影响,建立米格列奈群体药动学模型,并用Bootstrap和VPC法验证.结果:米格列奈在健康人体内药动学可用一室模型描述,个体间变异符合指数模型.米格列奈最终的群体药动学参数CL/F、表观分布容积(V/F)和吸收常数(Ka)的群体典型值分别为2.4L·h-1(24%)、9.82 L(4%)和6.46 h-1(14%).肌酐清除率(Ccr)因素对CL/F有显著影响,丙氨酸氨基转移酶(ALT)因素对Ka有显著影响.结论:肌酐清除率CCr和丙氨酸氨基转移酶ALT对米格列奈的群体药动学参数有显著影响.所建立的PPK模型可以较好地估算服用米格列奈的个体及群体药动学参数,为指导临床合理用药提供药动学参考.“,”Objective:To establish the population pharmacokinetics model of mitiglinide given by oral route in Chinese healthy volunteers using nonlinear mixed effect model (NONMEM), investigate the pharmacokinetic characteristics of mitiglinide in Chinese healthy people to evaluate the factors that can influence the clinical pharmacokinetics of mitiglinide .Methods: Clinical data from 22 healthy volunteers were collected and the experiment was with single-dose administration.The volunteers were given 10 mg mitiglinide calcium orally and mitiglinide plasma concentration was determined by LC-MS/MS.The data was analyzed by the first order conditional estimation, and the influences of fixed effect factors such as demographic index and biochemical index were quantitatively evaluated . The population pharmacokinetics model of mitiglinide was established , and the result was verified by using the VPC and self-test meth-od.Results:The result showed that mitiglinide pharmacokinetics was fit single-compartment model .The inter-individual variability could be described by an exponential model .The typical values including central volume of distribution , clearance and absorption con-stant was 2.4 L· h-1(24%), 9.82 L(4%) and 6.46 h-1(14%), respectively.The clearance was influenced by creatinine clear-ance rate , and the absorption constant was influenced by ALT .Conclusion:The population pharmacokinetic parameters were mainly influenced by creatinine clearance rate and ALT .The established population pharmacokinetics model can explain the reasons for the in -dividual variation in the plasma concentration of mitiglinide , which can be used to guide the clinical administration of Chinese people .
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