隔日口服地高辛治疗老人慢性充血性心力衰竭  

Treatment by intermittent oral administration of digoxin in elderly with chronic congestive heart failure

作　　者：萧伟懿 谢剑芬 沈志明[1] 

机构地区：[1]宝安区人民医院心血管内科,广东深圳518101 [2]宝安区人民医院急诊科,广东深圳518101

出　　处：《岭南心血管病杂志》2007年第6期431-433,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的对比隔日1次口服地高辛0.125mg或0.25mg治疗老人慢性充血性心力衰竭的临床疗效。方法慢性充血性心力衰竭老年患者86例,口服基础治疗药物有依那普利10mg,每日2次,氢氯噻嗪25mg,每日2次,氯化钾缓释片1.0g,每日1次。病人随机分为两组,分别隔日口服地高辛0.125mg或0.25mg,用放射免疫法测定血清地高辛浓度,用超声心动图测定左心室射血分数,记录心电图,观察心功能改变,随访6个月。结果两组治疗6个月后,地高辛稳态血药浓度在高剂量组高于低剂量组[(1.45±0.52)μg/L比(0.97±0.31)μg/L,P<0.01)],理想治疗窗(0.5～0.9μg/L)病例数在低剂量组多于高剂量组(19/43比4/43,χ2=13.354,P=0.000);左心室射血分数(0.47±0.05比0.46±0.05)和心功能分级改善差异无统计学意义(P>0.05),但地高辛中毒在高剂量组有4例,而低剂量组仅1例。结论地高辛隔日口服治疗老人充血性心力衰竭,剂量0.125mg与0.25mg疗效相当,但前者用药较安全。建议根据其血药浓度、肌酐清除率和心功能分级进行个体化用药,以达到最佳疗效。Objectives To compare effect of digoxin 0.125 mg and 0.25 mg orally every other day on the cardiac function in old patients with chronic congestive heart failure （CHF）. Methods Eighty-six old patients with chronic congestive heart failure were randomly divided into two groups. Convention therapy such as enalapril l0 mg b.i.d, hydrochlorothiazide 25 mg b.i.d, when using diuretics, oral potassium chloride slow release piece 1.0 g q.d. was taken. Group I （n=43） received digoxin 0.125 mg orally q.o.d. Group Ⅱ （n=43） received digoxin 0.25 mg orally q.o.d. Regular subsequent follow-up at each month continued for six months. Cardiac function was assessed by UCG, serum dlgoxin concentration （SDC） by ELISA and electrocardiogram were determined. Results The serum digoxin concentration in the group Ⅱ was higher than in the group Ⅰ [ （1.45±0.52） μg/L vs （0.97±0.31 ） μg/L, P〈0.01 ] ; The LVEF was no significant difference betweem the two groups in the improvement of cardiac function （LVEF 0.47±0.05 vs 0.46±0.05 P〉0.05）. Conclusions Both digoxin 0.125 mg and 0.25 mg orally q.o.d, for treatment of congestive heart failure are quite curative, but the former may be safe.

关 键 词：心力衰竭 充血性 地高辛 超声心动图 心功能 

分 类 号：R541.61[医药卫生—心血管疾病] R972.14[医药卫生—内科学]