3Y型连续混合输注装置中丙氨酰谷氨酰胺配伍稳定性考察.docxVIP

Y型连续混合输注装置中丙氨酰谷氨酰胺配伍稳定性考察张程亮，冯承阳，徐艳娇，余早勤，刘东（华中科技大学同济医学院附属同济医院药学部武汉430030）[摘要]目的：考察Y型连续混合输注装置中丙氨酰谷氨酰胺的配伍稳定性，为合理输注丙氨酰谷氨酰胺提供实验依据。方法：采用全自动冰点渗透压仪测定输注液渗透压；采用pH计测定输注液pH值；采用智能微粒检测仪测定输注液不溶性微粒数量。结果：实验各配伍组在Y型连续混合输注方式下，整个输液过程中pH值、不溶性微粒数量随时间变化不明显，渗透压在滴注半小时出现较大的波动。结论：推测Y型连续混合输注装置在边混合边注射输注过程中不能很好混匀各瓶溶液，建议在条件允许情况下提前预混丙氨酰谷氨酰胺和与其配伍溶液，并对患者的反应进行实时监测。此外，由于丙氨酰谷氨酰胺的渗透压较大，某些渗透压较大的溶液不适合作为丙氨酰谷氨酰胺的载体溶媒。[关键词]Y型连续混合输注装置；丙氨酰谷氨酰胺；配伍稳定性The study of alanylglutamine compatibility stability of using Y-type continuous mixing infusion deviceZhang Chengliang, FengChengyang,XuYanjiao, Yu Zaoqin, LiuDong（Department of Pharmacy, Tongji Hospital, Tongji Medical College，Huazhong University of Science and Technology, Wuhan 430030，China）ABSTRACT:OBJECTIVEBy studying the compatible stability of alanylglutamine when use Y-type continuous mixing infusion device toprovide experimental evidence for reasonable clinical use of alanylglutamine. METHODSOsmotic pressure was measured by using automatic freezing osmometer. pH was measured by using a pH meter. Quantity of insoluble particles was measured by using an intelligent particle detector. RESULTS pH and quantity of insoluble particles of these tested groups did not change significantly over time, but the osmotic pressure changed significantly over time. CONCLUSION Y-type continuous mixing infusion device may not mix each bottle of solution very well. If condition permitted, these solutions are advised premixed and real-time monitoring of the patients response is necessary. In addition, some high osmotic pressure solutions are not good vehicle for alanylglutamine.KEY WORDS: Y-type continuous mixing infusion device; Alanylglutamine; Compatible stability[通讯作者]：刘东，主任药师，研究方向为临床药学。Tel: 027E-mail：ld2069@谷氨酰胺是人体血及游离氨基酸池内含量最丰富的氨基酸，是合成蛋白质、核酸以及许多其他生物分子的前体物质。在肝脏、肾脏、骨骼肌和小肠中发挥着重要的调节作用[1]。机体在创伤感染等应激状态下，对谷氨酰胺的需求超过了自身的合成能力，需要及时进行外源性的补充[2]。多项研究证明谷氨酰胺对于提高危重症患者免疫力，改善预后具有重要作用[3]。目前常以谷氨酰胺二肽的形式（丙氨酰谷氨酰胺）用于临床输液，经由肠外营养液补充谷氨酰胺。丙氨酰谷氨酰胺注射液是一种高浓度溶液，说明书要求应以大于1：5的体积比与适宜的载体溶媒混合后输注，但是受到商品