摘要
目的 采用经验数学模型研究临床糖尿病患者胰岛素量 效关系。方法 8位糖尿病患者腹部注射普通胰岛素 14u ,7.5h内按一定时间间隔采取外周静脉血 ,测定血胰岛素浓度I(t)及血糖浓度G(t) ,I(t)用外周给药二室开放模型拟合 ,G(t)用经验模型 (G)t=a +b(t-d) -c(t-d)tanh(t-d)拟合 ,然后对函数I(t)与G(t)进行数学处理。结果 I(t)与G(t)无对应量效关系 ,I(t)与dG(t) /dt有对应量效关系。求得效应峰值Emax(mmol·h-1) ,平均效应Emean与药物敏感性 (mmol·mU-1·h-1)为 ( x±s) :(11.6± 3.9) ,(5 4.4± 13.7)和 (6 9.4± 2 7.5 ) ,Emax,Emean与年龄呈负相关。结论 胰岛素药效学研究中应把血糖浓度下降速率而非血糖浓度本身作为效应值。量效关系符合Clark式。糖尿病患者血糖对胰岛素的响应随患者年龄增大而下降。
OBJECTIVE: To study the dose-response of insulin in patients with diabetes by an empirical mathematical model. METHODS: 8 patients were enrolled. The concentrations of insulin and glucose in peripheral blood were measured at the time 0,0.5,1,1.5,2.5,3.5,4.5,5.5,6.5,7.5 h after injection of 14 u regular insulin in abdomen. The blood insulin concentration I(t) was fitted with an open two-compartment medel, I(t) = A·e-B(t-t0)+ C·e-D(t-t0)- (A+C)e-E(t-t0)+ F·e-Dt and the glucose concentration [G(t)] was fitted with an empirical model: G(t) = A + B(t-D) - C(t-D) tanh (t-D). RESULT: A dose-response relation between I(t) and dG(t)/dt was found. The maximum effect (mmol·h-1) and mean effect and the sensitivity of insulin action were shown as (x¯ ± s) : (11.6 ± 3.9), (54.4 ± 13.7) and (69.4 ± 27.5). The statistic correlation between Emax, Emean and the age of patients was found (P<0.05). CONCLUSION: It was indicated that the response of insulin should be the decreasing rate of the glucose [dG(t)/dt] rather than G(t). The dose-response curve was fitted well with the Clark equation. The effect of insulin decreased with the increasing of the age of the patients. Further research is needed to confirm the availability of clinical application of the method.
出处
《中国药学杂志》
EI
CAS
CSCD
北大核心
2002年第1期45-47,共3页
Chinese Pharmaceutical Journal
关键词
胰岛素
药效学
糖尿病
量-效分析
经验数学模型
Blood
Drug dosage
Glucose
Insulin
Mathematical models
Statistical methods
