951例心功能不全患者地高辛血清浓度的监测分析  

An Analysis of the Serum Digoxin Concentration Monitoring in 951 Patients with Cardiac Insufficiency

作　　者：谢守霞[1] 张万帆[1] 董淳 王大果 

机构地区：[1]暨南大学医学院附属第二医院,深圳市人民医院药学部,518020

出　　处：《医药导报》2003年第12期890-892,共3页Herald of Medicine

摘　　要：目的 :了解地高辛血清浓度的监测情况。方法 :调查深圳市人民医院 1998～ 2 0 0 0年 3a完成的 95 1例心功能不全患者地高辛血清浓度监测数据 ,并分析年龄对地高辛血清浓度的影响。结果 :地高辛血清浓度在有效范围内比例逐年上升 ,低于治疗范围的比例较高 ,高出治疗范围的比例较低 ;高于治疗范围的患者中毒率为 5 3 .6% (5 2 97) ,有效浓度内患者中毒率为 1.3 % (6 470 ) ;70岁以上组血清浓度明显高于其他年龄组 ,年龄与血清浓度超出正常范围的比例间无明显相关性 ;中毒的临床表现以心律失常 (5 4.2 % )和消化道反应 (3 4.7% )为主 ;中毒原因有血肌酐增高、高血钾、低血钾及伴发感染等。结论 :地高辛血清浓度监测能较好地反映地高辛临床疗效 ,地高辛浓度正常不能排除药物中毒的可能性 。Objective:To understand the state of serum digoxin monitoring. Methods: An investigation was made into the data of serum digoxin monitoring in 951 patients with cardiac insufficiency carried out in the People's Hospital of Shenzhen City within 3 years from 1998～2000, with an emphasis upon the influence of age on the serum concentration of digoxin. Results:There was a year by year increase in the percentage of serum digoxin concentrations within the effective range (0.8～2.0 μg·mL 1 ). The percentage of serum digoxin concentrations lower than the therapeutic range (<0.8 μg·mL 1 ) was relatively large while that higher than the therapeutic range, relatively small. The incidence of digoxin intoxication in patients with serum digoxin concentrations higher than the therapeutic range was 53.6%(52/97), while that in patients with serum digoxin concentrations within the therapeutic range was 1.3%(6/470). Serum digoxin concentrations in patients over 70 years of age were significantly higher than those in patients of other age groups. No apparent correlation was shown between age and the percentage of serum digoxin concentrations exceeding the therapeutic range. The major clinical manifestations of digoxin intoxication were cardiac arrhythmias(54.2%) and gastrointestinal reactions (34.7%). The causes of digoxin intoxication included increase in serum creatinine, hyperkalemia, hypokalemia and concomitant infections. Conclusion:Serum digoxin concentration monitoring was shown to cast fairly good reflections of the clinical therapeutic effects of digoxin. The possibility of digoxin intoxication could not be ruled out by normal serum digoxin concentrations. Stress should be laid on aged patients in the clinical monitoring.

关 键 词：地高辛 治疗药物监测 血清浓度 中毒 

分 类 号：R972.1[医药卫生—药品] R541.6[医药卫生—药学]