我院101例地高辛中毒临床相关因素分析  

Analysis of Related Clinical Factors of 101 Cases of Digoxin Toxication in Our Hospital

作　　者：李倩[1] 王雪明[1] 西娜[1] 

机构地区：[1]解放军第309医院药剂科,北京100091

出　　处：《中国药房》2015年第2期209-212,共4页China Pharmacy

摘　　要：目的:探讨导致地高辛中毒浓度的因素,为临床安全、有效、合理使用强心苷类药物提供参考。方法:采用微粒酶免疫测定法测定地高辛的血药浓度,对达地高辛中毒的101例患者病历进行分析。结果:60岁以上患者的血药浓度显著高于60岁以下的患者;随着给药剂量的增加,患者血药浓度增加;多数患者伴有电解质紊乱、高血压、肾功能不全、心功能不全、糖尿病、甲状腺功能减退、慢性阻塞性肺疾病,其地高辛的平均血药浓度分别为(2.87±0.72)、(2.80±0.69)、(2.80±0.64)、(2.75±0.62)、(2.69±0.62)、(2.57±0.27)、(2.54±0.56)ng/ml,合并以上疾病种类越多,对地高辛浓度影响越大;与硝苯地平、去乙酰毛花苷、呋塞米、胺碘酮、螺内酯、氢氯噻嗪、伏立康唑、托拉塞米合并用药时,地高辛平均血药浓度分别为(3.17±0.82)、(3.06±0.68)、(2.86±0.71)、(2.80±0.62)、(2.79±0.65)、(2.57±0.46)、2.41、2.12 ng/ml。结论:年龄对地高辛血药浓度有显著影响,随着年龄增大,地高辛血药浓度呈增高的趋势。除此之外,给药剂量和各种病理、生理状态以及合并用药等均对地高辛血药浓度有影响。OBJECTIVE： To discuss the factors of toxic concentration of digoxin, and to provide safe, effective and rational use of cardiac glycoside. METHODS： MEIA was developed for the determination of blood concentration of digoxin, and the clini- cal data of 101 patients with toxic blood concentration of digoxin were analyzed. RESULTS： The blood concentration of patients over 60 years old was significantly higher than that of patients less than 60 years old. The blood concentration of patients increased with the increasing of the dose. Most patients was accompanied by electrolyte disorders, hypertension, renal insufficiency, cardiac insufficiency, diabetes mellitus, hypothyroidism, chronic obstructive pulmonary disease, and the average blood concentration of digoxin were （2.87 ± 0.72）, （2.80 ± 0.69）, （2.80 ± 0.64）, （2.75 ± 0.62）, （2.69 ± 0.62）, （2.57 ± 0.27） and （2.54 ± 0.56） ng/ml. The more combined the above diseases, the greater impact on blood concentration of digoxin. When digoxin combined with nife- dipine, deslanoside, furosemide, amiodarone, spironolactone, hydrochlorothiazide, voriconazole or torasemide, the average blood concentration of digoxin were （3.17 ± 0.82）, （3.06 ± 0.68）, （2.86 ± 0.71）, （2.80 ± 0.62）, （2.79 ± 0.65）, （2.57 ± 0.46） ,2.41 and 2.12 ng/ml, respectively. CONCLUSIONS： Blood concentration is influence by ages significantly; along with increasing age, blood concentration of digoxin is increasing. In addition, drug dosage, pathological and physiological changes and drug combina- tion all influence the blood concentration of digoxin.

关 键 词：地高辛 中毒浓度 影响因素 

分 类 号：R972.1[医药卫生—药品] R197.323[医药卫生—药学]