住院患者2064例血清地高辛浓度监测分析  

Monitoring and analysis of digoxin blood concentration in 2064 inpatients

作　　者：谭嘉琦 黄裕立 胡允兆 TAN Jia-qi;HUANG Yu-li;HU Yun-zhao(Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan 528300, Guangdong, China)

机构地区：[1]南方医科大学顺德医院心内科

出　　处：《广东医学》2019年第18期2610-2614,共5页Guangdong Medical Journal

基　　金：佛山市科技计划项目(编号:2016AB003353);佛山市科技创新平台项目(编号:FS0AA-KJ218-1301-0006,FS0AA-KJ218-1301-0010);南方医科大学顺德医院临床研究启动项目(编号:CRSP2019001)

摘　　要：目的回顾性分析住院患者血清地高辛浓度监测情况,为临床合理用药提供参考。方法根据纳入及排除标准收集住院患者2 064例的血清地高辛浓度。地高辛的血药浓度测定采用化学发光免疫分析法。分别按年龄段、性别、地高辛血药浓度、科室进行分组比较。结果地高辛血药浓度监测例数呈逐年下降趋势。根据ACC/AHC指南,有500例(24.2%)在推荐的参考值范围。诊断地高辛中毒共136例(6.6%)。>65岁患者有1 475例(71.5%),两组年龄段患者相比,>65岁组地高辛血药浓度更高(P<0.05),诊断地高辛中毒例数更多(P<0.05)。以地高辛浓度1.2μg/L作分界点,男女构成比差异有统计学意义(P<0.05)。与男性相比,女性诊断地高辛中毒的例数更多(P<0.05),但院内全因死亡率在男女性别之间差异无统计学意义(P>0.05)。心内科诊断地高辛中毒有57例,占全院首位。结论临床医务人员必须规范使用地高辛药物,及时监测地高辛浓度;对于老年患者更需要注意个体化的方案,结合患者的病理生理情况,合理调整给药方案,达到安全有效地使用地高辛的目的。Objective To retrospectively analyze serum digoxin concentration in Shunde Hospital of Southern Medical University, thus to provide reference for clinical rational drug use. Methods Serum digoxin concentrations of 2 064 inpatients from January 2013 to December 2017 in Shunde Hospital of Southern Medical University were collected according to inclusion and exclusion criteria. The blood concentration of digoxin was determined by chemiluminescence immunoassay. According to age, sex, digoxin blood concentration and department, they were divided into groups and compared. Results The number of monitoring cases of digoxin blood concentration showed a downward trend year by year. According to ACC/AHC guidelines, 500 cases(24.2%) were within the recommended reference range. Digoxin poisoning was diagnosed in 136 cases(6.6%). There were 1 475 patients over 65 years old(71.5%). Compared with patients between the two groups, the blood concentration of digoxin in patients over 65 years old was significantly higher(P<0.05), and the digoxin poisoning cases diagnosed was also significantly more(P<0.05). Taking digoxin concentration of 1.2 μg/L as the dividing point, there was a statistical difference in the composition ratio between men and women(P<0.05). Compared with men, the digoxin poisoning cases diagnosed in women was significantly more(P<0.05), but there was no significant difference between male and female in all-cause mortality in hospital(P>0.05). Fifty-seven cases of digoxin poisoning were diagnosed in cardiology department, accounting for the first place in the hospital. Conclusion Clinical medical staff must standardize the use of digoxin drugs and monitor digoxin concentration in time. For the elderly patients, it is necessary to pay more attention to the individualized scheme, and to adjust the administration scheme reasonably according to the patients′ pathophysiological conditions, so as to achieve the purpose of safe and effective use of digoxin.

关 键 词：地高辛 血药浓度 监测 中毒 

分 类 号：R917[医药卫生—药物分析学] R972[医药卫生—药学]