合并用药对有无肾损伤患者地高辛血药浓度影响因素分析  

Effects analysis of serum Digoxin concentration under combined medication to the renal impairment patients and normal renal patients

作　　者：王梓坤[1,2] 陈舒晴[1,3] 周颖[1] 赵侠[1] 许俊羽[1] 崔一民[1] 

机构地区：[1]北京大学第一医院药剂科,北京100034 [2]中国药科大学 [3]北京大学医学部药学院药事管理与临床药学系,北京100191

出　　处：《中国临床药理学与治疗学》2016年第1期71-76,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：国家自然科学基金资助项目(81373487)

摘　　要：目的:探讨在有无肾功能损伤的情况下,合并用药及其他因素对地高辛血药浓度(serum Digoxin concentration,SDC)的影响,促进合理用药。方法:回顾性分析了北京大学第一医院2014年口服地高辛治疗并进行治疗药物监测(therapeutic drug monitoring,TDM)住院患者的病历。结果:55例肾功能基本正常的患者口服地高辛、合并使用抗菌药及噻嗪类利尿剂时对SDC影响较大;78例肾功能受损的患者口服地高辛、合并使用抗凝剂时对SDC影响较大;其他因素,如年龄对地高辛的代谢也有显著影响。结论:在有无肾功能损伤的情况下,合并用药均会影响SDC,为确保地高辛使用的安全性,监测其血药浓度意义重大。AIM： To investigate the serum Digoxin concentration under combined medication to the renal impairment patients and normal renal patients,and may promote rational drug use.METHODS： The medical records of inpatients in Peking University First hospital who took Digoxin orally and made therapeutic drug monitoring in 2014 were retrospectively analyzed.RESULTS： In the two study cohorts,55 patients without renal impairment were taken Digoxin and combination treatment with antibacterial and thiazine diuretics.It was found that the serum Digoxin concentration increased apparently.78 patients with renal impairment were taken Digoxin and combined with anticoagulant inhibitors,the serum Digoxin concentration changed significantly also.Other factors,such as age,had significant impact on drug metabolism, too.CONCLUSION：The data of serum Digoxin concentration are affected by combined medication in both renal impairment patients and normal renal patients.To ensure the safety,monitoring serum Digoxin concentrations is a crucial issue especially in combination treatment.

关 键 词：地高辛 肾功能损伤 合并用药 血药浓度 用药监护 

分 类 号：R969.3[医药卫生—药理学]