糖皮质激素类药物对学龄前儿童CYP3A酶活性的影响
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篇名: 糖皮质激素类药物对学龄前儿童CYP3A酶活性的影响
TITLE:
摘要: 目的:研究糖皮质激素类药物对学龄前儿童体内细胞色素P450 3A(CYP3A)酶活性的影响。方法:选择厦门地区528例健康学龄前儿童为正常儿童组;68例支气管炎患儿据给药方案的差异分为雾化吸入组(31例)和静脉给药组(37例),分别予布地奈德1 mg雾化吸入,bid或甲泼尼龙1~2 mg,ivgtt,bid。采用反相高效液相色谱(RP-HPLC)法测定3组受试儿童尿液中6β-羟基氢化可的松和氢化可的松的质量浓度,以两者质量浓度比来表示CYP3A酶活性。考察3组受试儿童CYP3A酶活性的分布特征及差异。结果:正常儿童组、雾化吸入组、静脉给药组受试儿童CYP3A酶活性均呈左偏态分布(P<0.05,偏度系数>1)。3组受试儿童CYP3A酶活性分别为4.28(1.90,7.69)、5.80(2.11,11.23)、7.79(1.93,19.44),差异有统计学意义(P<0.05)。正常儿童组酶活性中位数低于静脉给药组,差异有统计学意义(P<0.05);雾化吸入组酶活性中位数略高于正常儿童组,静脉给药组酶活性中位数略高于雾化吸入组,但差异均无统计学意义(P>0.05)。结论:使用糖皮质激素类药物可能会影响学龄前儿童CYP3A酶活性,且全身使用糖皮质激素类药物可改变其酶活性。
ABSTRACT: OBJECTIVE: To study the effects of corticosteroids on CYP3A activity in children at pre-school age. METHODS: 528 healthy children at pre-school age in Xiamen were included in normal children group; 68 children diagnosed as bronchitis were divided into aerosol inhalation group (31 cases) and intravenous administration group (37 cases) according to therapy plan, and they were given budesonide 1 mg, aerosol inhalation, bid or methylprednisolone 1-2 mg, ivgtt, bid. RP-HPLC method was established to determinate the concentrations of 6β-hydroxycortisol and hydrocortisone in urine,and the ratio of 6β-hydroxycortisol and hydrocortisone was used to represent CYP3A activity. Distribution and difference of children CYP3A activity were investigated in 3 groups. RESULTS: The frequency distribution of CYP3A activity in all the 3 groups was a left skewness distribution (P<0.05, coefficient of skewness>1). CYP3A activity of 3 groups were 4.28(1.90,7.69), 5.80(2.11,11.23) and 7.79(1.93,19.44)respectively, with statistical significance (P<0.05). Median CYP3A activity of normal children group was lower than that of intravenous administration, with statistical significance (P<0.05). Median CYP3A activity of aerosol inhalation group was higher than normal children group, median CYP3A activity of intravenous administration group was higher than aerosol inhalation group, with no statistical significance (P>0.05). CONCLUSIONS: Corticosteroids may influence CYP3A activity in children at pre-school age, and corticosteroids used all over body may change CYP3A activity.
期刊: 2016年第27卷第11期
作者: 万隽,张晓光,陈瑶
AUTHORS: WAN Jun,ZHANG Xiaoguang,CHEN Yao
关键字: 糖皮质激素;学龄前儿童;细胞色素P450 3A酶;酶活性
KEYWORDS: Corticosteroids; Children at pre-school age; CYP3A; Enzyme activity
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