CN102397290A - Hydroxyethyl starch injection and preparation method thereof - Google Patents

Hydroxyethyl starch injection and preparation method thereof Download PDF

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CN102397290A
CN102397290A CN2011101748618A CN201110174861A CN102397290A CN 102397290 A CN102397290 A CN 102397290A CN 2011101748618 A CN2011101748618 A CN 2011101748618A CN 201110174861 A CN201110174861 A CN 201110174861A CN 102397290 A CN102397290 A CN 102397290A
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injection
hetastarch
hydroxyethyl starch
chloride
glucose
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CN102397290B (en
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万鹏
韦家华
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LIAONING HISHEN LIANSHENG PHARMACEUTICAL CO LTD
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LIAONING HISHEN LIANSHENG PHARMACEUTICAL CO LTD
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Abstract

The present invention provides a hydroxyethyl starch 130/0.4 sodium chloride injection, wherein the injection uses hydroxyethyl starch 130/0.4 as the main raw material, and further contains sodium chloride, potassium chloride, calcium chloride, glucose and sodium acetate. (1) The injection has the reasonable formula, and the capacity expanding time of the hydroxyethyl starch 130/0.4 injection of the invention and the stay time in vivo is better than that of the hydroxyethyl starch injection of the prior art. (2) The injection has well stability, and the injection property, the clarity and the content and the stabilization of the molecular weight of the hydroxyethyl starch 130/0.4 can also be kept for long time preservation. (3) The injection has the short capacity expanding time and takes fast effect in the treatment of hemorrhagic shock. (4) The injection is more approaching to the human body internal environment, is propitious to regulate the body fluid, balance the electrolyte, and reduce the damage to the liver and kidney function.

Description

A kind of hydroxyethyl starch injection liquid and preparation method thereof
Technical field
The present invention relates to a kind of hydroxyethyl starch injection liquid as blood plasma substitute, a kind of hetastarch (130/0.4) injection especially is provided.Belong to field of medicaments.
Background technology
From the thirties in 20th century, since the gelatin gels plasma substitute comes out, existing so far nearly 80 years history.Invented the polyvinylpyrrolidone (PVP) of synthetic during the World War I; The synthetic dextrorotation candy of microorganism acid anhydride (Dextran) has appearred again in World War II; The mid-1970s U.S. develop hetastarch (HydroxyethylStarch, HES), China is by blood transfusion of China Concord Medical Science University, the Chinese Academy of Medical Sciences and Blood Research Institute; Studied successful dextrorotation candy acid anhydride and hetastarch respectively in 1958 and 1967; And forming industrialization at home rapidly, this has brought into play significant role to China prevention and treatment Hypovolemia and shock patients, has saved millions of life.Clinically; The hetastarch volume treatment of doing commonly used; Behind the intravenously administrable, the blood volume that can increase sharply is usually used in treatment because of massive hemorrhage; Burn or other wounds shock or the hemorrhage that cause can prevent each organic blood flow volume that circulatory disturbance that the backflow blood volume causes causes, the minimizing of oxygen confession amount and the organ failure of appearance.Experimentation and the clinical application practice of decades show, really estimate from clinical practice safety and blood plasma dilatation dose-effect, and hetastarch has become first-use drug--the blood plasma substitute that common people are used to treat the shock patient that losing blood property and a variety of causes cause.Abroad report in the period of 1978 to 1992 15, three kinds of blood plasma substitute quantity of clinical use gelatin, dextrorotation candy acid anhydride, hetastarch relatively, to hetastarch consumption in 1992 be that the first two plants more than 10 times; Aspect safety, see with the anaphylaxis of clinical worry the most, also be that hetastarch is minimum (0.054%), only be equivalent to 1/6 of gelatin, 1/4.7 of dextrorotation candy acid anhydride, even than also low one times of human albumin; Add raw material from natural corn, not only obtain easily but also good and cheap, and relatively letter of technology, be convenient to promote and produce.Because the chemical composition and the similar of hetastarch are former in the human body glycogen, be easy to metabolism at the blood vessel internal recycle in addition, the overwhelming majority is discharged from urine, thereby in organ, does not almost have savings, and vast clinical position person is happy to adopt.
Abroad, the hetastarch sodium chloride injection is at country variant, and its selected clinically kind is different; The hetastarch mean molecule quantity is 480KD ten thousand on American market; Mainly produced by du pont company (DuPont), commodity respectively are HESPan, and this product is widely used in the U.S.; Its blood volume expands big, and is lasting and effective.6% (480/0.7) average out to 24h action time, the defective on the performance is that it is influential and poultry is long-pending in vivo to blood coagulation system, and the ($43/500ml 6%480/0.7 that costs an arm and a leg) thereby limited its application clinically.On the European market, German Fresenius card has been succeeded in developing commodity He Si (HAES) 200/0.5 hetastarch product by name than company (Fresenius kabi) in nineteen eighty-two, and this product occupies the European market more than 70%; And in accurate Chinese market, this product mean molecule quantity 200KD, the substitution value 0.43-0.55 of getting into of quilt in 1999; Be used for blood plasma substitute, dilatation intensity is big, and it is 100% that the 6%HES dilatation is renderd a service; Dilatation effective time 4-8 hour, the half-life is 3-4 hour, irritated incidence rate is low; Be the leading products on the European blood plasma substitute market, it is 130KD that nearest Fresenius card is released its mean molecule quantity of hetastarch product Voluven of new generation again than company, and substitution value is 0.4; They think a lower molecular weight and a low mole degree of exchange can further improve Product Safety and effectiveness.Through the research that concerns between hetastarch chemical constitution characteristics and the physiological function is shown; Bigger its dilatation intensity of hetastarch mean molecule quantity is big more; Molecular weight size decision dilatation is renderd a service; Half-life length in its blood circulation of degree of exchange size decision is made a general survey of external hetastarch development and can be found out, hetastarch just from the high mole of HMW degree of exchange towards low-molecular-weight and low degree of exchange production development.Homemade hetastarch 40 or 20 products (706 plasma substitute); Because molecular weight is lower; And degree of exchange higher (0.8-1.2), blood plasma dilatation effect is relatively poor, and the half-life is shorter in the blood circulation; The anti-hemorrhagic shock function is lower, and clinical at home being mainly used in improved blood flow, treatment circulation or microcirculation disturbance patient.
Hetastarch is a third generation artificial colloid, is to be processed after degraded, hydroxyethylation and further processed by the HMW amylopectin.Press molecular weight and divide, low-molecular-weight hetastarch (Mw40000-7000D), middle molecular weight hydroxyethyl starch (Mw1300000-2000000D) and high molecular weight hydroxyethyl starch (Mw4500000-4800000D) are arranged.Divide by the replacement degree, low level hetastarch (Ms0.3-0.5) and the high level hetastarch (Ms0.6-0.7) that replaces of replacing arranged.What use always on the Chinese market at present mainly is hetastarch 200/0.5; The hetastarch of molecular weight in the genus; This article beginning of the nineties in last century is succeeded in developing (trade name: He Si HES), and successively in some country's listings, especially use the most extensive in Europe by German Fresenius company.He Si got into Chinese market in 1998, received clinician's welcome.Become the leading products on the present market.But single hetastarch 200/0.5 preparation still can not satisfy clinical demand.
Clinically, hetastarch is widely used in artificial plasm's succedaneum.Announced a kind of hydroxy ethyl starch for injection and preparation method thereof among the CN1650885A.CN1235833A, CN1195527A have announced the injection of hetastarch, be made up of hetastarch and sodium chloride, but there are the deficiency that causes high chlorine property metabolic acidosis easily in it when using.
Summary of the invention
Be safety and the effectiveness that improves clinical use, the present invention aims to provide a kind of human internal environment that more meets, and has reliable and stable capacity effect and persistent period, can fastly put in order effective dilatation and improve hypovolemic shock patient's the state of an illness.Hetastarch 130/0.4 injection of the present invention has good stable property, and clinical use is safer, effective.
Technical scheme of the present invention is following:
A kind of hetastarch 130/0.4 injection; Is to be 130 with weight average molecular weight with hetastarch as plasma expander; 000 dalton; The molar substitution level is that 0.4 (130/0.4) hetastarch is a primary raw material, and contains sodium chloride, potassium chloride, calcium chloride, glucose and sodium acetate composition.
The embodiment of hetastarch 130/0.4 injection according to the invention, described hydroxyethyl starch injection liquid contains in wherein every 100ml injection: hetastarch 130/0.48-10g; Sodium chloride 0.5-1.0g; Glucose 0.05-0.1g, potassium chloride 0.02-0.04g, calcium chloride 0.02-0.04g; Sodium acetate 0.01-0.02mg, surplus is a water for injection.
As the preferred embodiments of the invention, described hetastarch 130/0.4 injection contains in wherein every 100ml injection: hetastarch 130/0.4 8g; Sodium chloride 0.5g, glucose 0.1g, potassium chloride 0.02g; Calcium chloride 0.02g, sodium acetate 0.01mg, surplus is a water for injection.Hydroxyethyl starch injection liquid people pH value of the present invention is 5-7, preferably 6.5-7.
The method for preparing of hetastarch 130/0.4 injection according to the invention:
(1) takes by weighing hetastarch 130/0.4, sodium chloride, potassium chloride, calcium chloride, glucose and the sodium acetate of recipe quantity, mix, add water for injection and dissolve fully;
(2) activated carbon adsorption: the needle-use activated carbon decolouring of adding 0.1%, boil insulation 20 minutes, adjust pH is to 5.0-7.0;
(3) fine straining: with diameter 0.45um microporous filter membrane; Fill; In 115 ℃ of sterilizations 30 minutes; Lamp inspection, packing; Get injection.
Above-mentioned described hydroxyethyl starch injection liquid can be used as artificial plasm's succedaneum.As be used to treat hypovolemic shock, for example lose hemorrhagic shock, septic shock, burn and traumatic shock; Perhaps reduce operation blood consumption, like ANH, the property controlled blood property dilution etc.
Hetastarch 130/0.4 injection of the present invention contains sodium, potassium, the calcium that approaches the normal physiological level, more meets human internal environment's demand.In addition, also contain glucose in hetastarch 130/0.4 injection of the present invention, helping provides energy to patient, reduces protein depletion.In addition, also contain acetic acid in hetastarch 130/0.4 injection of the present invention.Sodium acetate is dissociated into Na in the water +And C 3H 5O 3 -Acetate anion is an alkalescence, removes acetic acid and hydrion simultaneously through liver.In liver, acetic acid is metabolised to glycogen, and final oxidized metabolism changes into carbon dioxide and water.Produce and utilization when acetic acid is normal, can not cause that acetic Acid Metabolism is disorderly, acetate anion can be used as the alternate source of bicarbonate radical.
Hetastarch 130/0.4 injection of the present invention, its Cl-level more approaches the normal physiological scope than 0.9% sodium chloride injection, and contains near physiological level Ca 2+, K +, Na+, C 3H 5O 3-, electrolyte such as glucose, dilatation is suitable with its sodium chloride injection, and more helps improving hypovolemic shock patient's water-electrolyte balance.
The hetastarch 130/0.4 that uses in the plasma substitute injection of the present invention; Belong to a kind of middle molecular weight hydroxyethyl starch; Its molecular weight is 130000 left and right sides dalton, and molecular distribution is more concentrated, further reduces than the existing molecular weight of 200/0.5 hetastarch of report that uses; The replacement level of ethoxy is reduced to 0.4 from 0.5, and can be with the mode of replacement from C 2With C 5(or C 6) ratio increased to 9: 1 by 5: 1, help obtaining better effect.On this basis, simultaneously again with sodium acetate and the common compound injection of forming of multiple electrolyte ingredient optimum organization, make it and can reach the target of " desirable colloid solution ".It not only can provide reliable and stable capacity effect and persistent period; And more meet the interior environment of human blood; Influence and the effect of expansion blood appearance to blood system also all are superior to plasma substitutes such as hetastarch 200/0.5 sodium acetate ringer's injection; More ideal comprehensive therapeutic effect can be arranged, also convenient clinical use.
Therefore, when adopting these article treatments hypovolemic shock patient, compare with existing expander, can replenishment of blood content and multiple electrolyte ingredient to regulate body fluid, electrolyte and acid-base balance.Simultaneously, less to the detrimental effect of renal function, can not produce high chlorine property metabolic acidosis, clinical use is safer, improves the safety and the effectiveness of clinical use.And can practice thrift blood used in clinic, and solved the nervous problem in blood source to a great extent, reduced the complication of allosome blood transfusion, the effectiveness and the safety that have also improved volume treatment greatly, and thus to the prognosis of disease with lapse to the generation wholesome effect.
The compared with prior art the most outstanding advantage of the present invention is: the prescription of (1) injection is reasonable, dilatation time of hetastarch 130/0.4 the injection of the present invention and time of staying is superior to the hydroxyethyl starch injection liquid of prior art in vivo; (2) good stability, long preservation still guarantee the stable of injection character, clarity, hetastarch 130/0.4 content and molecular weight; (3) the dilatation time short rapid-action, onset rapidly in treating hemorrhagic shock; (4) more approach human interior environment, help regulating body fluid, electrolyte balance, reduce liver, renal function injury.
Below again foregoing of the present invention is done further to specify through the specific embodiment of embodiment.But should this be interpreted as that the scope of the above-mentioned theme of the present invention only limits to following instance.Do not breaking away under the above-mentioned technological thought situation of the present invention, various replacements or change according to ordinary skill knowledge and customary means are made all should comprise within the scope of the invention.
Inventive embodiments
Embodiment 1
Injection is formed (by every 100ml injection):
Figure BSA00000525421000051
(1) takes by weighing hetastarch 130/0.4, sodium chloride, potassium chloride, calcium chloride, glucose and the sodium acetate of recipe quantity, mix, add water for injection and dissolve fully;
(2) activated carbon adsorption: the needle-use activated carbon decolouring of adding 0.1%, boil insulation 20 minutes, adjust pH is to 6.5-7.0;
(3) fine straining: with diameter 0.45um microporous filter membrane; Fill; In 115 ℃ of sterilizations 30 minutes; Lamp inspection, packing; Get injection.
Embodiment 2
Injection is formed (by every 100ml injection):
Method for preparing is with embodiment 1.
Embodiment 3
Injection is formed (by every 100ml injection):
Figure BSA00000525421000062
Method for preparing is with embodiment 1.
Embodiment 4
Injection is formed (by every 100ml injection):
Figure BSA00000525421000071
Method for preparing is with embodiment 1.
Galenic pharmacy is investigated
(1) freezing-thawing test
In the freezing-thawing test, the sample of selecting embodiment 1-4 was respectively placed two days respectively under-10 ℃ and 40 ℃ of acceleration environments, then checked clarity of solution, clarity and principal agent (hetastarch (130/0.4)) content, and the result sees table 1.
Table 1 freezing and thawing test result
Figure BSA00000525421000072
Figure BSA00000525421000081
Can know that by the result before and after the freezing-thawing test, clarity of solution, clarity and molecular weight be no change almost.After the freezing-thawing test, visible hetastarch 130/0.4 injection of the present invention.
(2) accelerated stability test
In the long-time stability examination; Select the sample of embodiment 1-4, carry out each sample with reference to Chinese Pharmacopoeia appendix XIXC crude drug pharmaceutical preparation stability test guideline; Get three batches; In temperature is 40 ℃ ± 2 ℃, and relative humidity is 75% ± 5% condition held 6 months, respectively at 1,2,3, the sampling in June investigates character, microorganism qualification, visible foreign matters, principal agent (hetastarch (130/0.4)) content, the pH value of sample.The result is following:
Table 2 accelerated stability test result (January)
Figure BSA00000525421000082
Figure BSA00000525421000091
Table 3 accelerated stability test result (February)
Figure BSA00000525421000092
Table 4 accelerated stability test result (March)
Figure BSA00000525421000102
Table 5 accelerated stability test result (June)
Figure BSA00000525421000111
(3) pharmacodynamics and dilatation effect test
Hetastarch (130/0.4) injection of selecting embodiment 1-4 for use is as sample, evidence beneficial effect of the present invention in rat hemorrhagic shock model.After the administration 30 minutes, measure the mean arterial pressure lift-off value.
Hetastarch (130/0.4) injection of table 6 embodiment 1-4 is to the mean arterial pressure lift-off value
Embodiment 1 2 3 4
Mean arterial pressure 85 90 87 88
Lift-off value mmHg
It is thus clear that the hetastarch of embodiment 1-4 (130/0.4) injection is onset rapidly in treating hemorrhagic shock.
Infusion 500ml sample behind the hemorrhage 500ml of healthy volunteer, sample are selected from hetastarch (130/0.4) injection of embodiment 1-4, can produce the volume replacement effect to losing blood.Measure the time of staying in hetastarch (130/0.4) body, and dilatation is relaxed the notes time.
In sum, prior art of the present invention is compared the most outstanding advantage and is: the prescription of (1) injection is reasonable, dilatation time of hetastarch 130/0.4 the injection of the present invention and time of staying is superior to the hydroxyethyl starch injection liquid of prior art in vivo; (2) good stability, long preservation still guarantee the stable of injection character, clarity, hetastarch 130/0.4 content and molecular weight; (3) the dilatation time short rapid-action, onset rapidly in treating hemorrhagic shock; (4) more approach human interior environment, help regulating body fluid, electrolyte balance, reduce liver, renal function injury.
The present invention is described according to preferred embodiment.The description and the embodiment that should be understood that the front are just to illustrating the present invention.Under prerequisite without departing from the spirit and scope of the present invention, those skilled in the art can design multiple alternative of the present invention and improvement project, and it all should be understood to be within protection scope of the present invention.

Claims (4)

1. hetastarch 130/0.4 injection; Is to be 130 with weight average molecular weight with hetastarch as plasma expander; 000 dalton; The molar substitution level is that 0.4 (130/0.4) hetastarch is a primary raw material, and contains sodium chloride, potassium chloride, calcium chloride, glucose and sodium acetate composition.
2. described hetastarch 130/0.4 injection of claim 1, described hydroxyethyl starch injection liquid contains in wherein every 100ml injection: hetastarch 130/0.4 8-10g; Sodium chloride 0.5-1.0g; Glucose 0.05-0.1g, potassium chloride 0.02-0.04g, calcium chloride 0.02-0.04g; Sodium acetate 0.01-0.02mg, surplus is a water for injection.
3. the method for preparing of claim 1 and 2 hetastarch 130/0.4 injection; It is characterized in that: (1) takes by weighing hetastarch 130/0.4, sodium chloride, potassium chloride, calcium chloride, glucose and the sodium acetate of recipe quantity; Mix, add water for injection and dissolve fully;
(2) activated carbon adsorption: the needle-use activated carbon decolouring of adding 0.1%, boil insulation 20 minutes, adjust pH is to 6.5-7.0;
(3) fine straining: with diameter 0.45um microporous filter membrane; Fill; In 115 ℃ of sterilizations 30 minutes; Lamp inspection, packing; Get injection.
4. described hetastarch 130/0.4 injection of claim 1-3 has application at the medicine that preparation is used for treating hemorrhagic shock.
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CN110520131A (en) * 2017-04-18 2019-11-29 马瑞纳斯制药公司 The neurosteroid preparation of sustained release injectable
WO2022045903A1 (en) * 2020-08-25 2022-03-03 Cytorex International, Inc. Method for producing mixtures to achieve ionic compositions for therapeutic use, which can be administered to humans or animals orally, parenterally, intraperitoneally, topically, otically, nasally or by means of washes, which result in improvement in diseases

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