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目的检测地高辛血药浓度,为临床安全、有效、合理使用地高辛提供参考依据。方法调查该院2010年3～11月检测的105例患者地高辛血药浓度监测数据,并分析个体差异及年龄对地高辛血药浓度的影响。结果低于治疗范围1.0～2.6nmol/L低限者即小于1.0nmol/L的有25例患者,均未出现中毒症状;在有效治疗浓度范围内共70例患者中有6例出现中毒症状,占8.57%,高于治疗范围的共10例患者中有7例出现中毒症状,占70%;105例检测结果中共13例出现中毒症状,占监测例数的12.38%。中毒的临床表现以心律失常和消化道反应为主;中毒原因除个体差异外有合并用药、血肌酐增高、高血钾等。结论地高辛血药浓度监测能较好地反映地高辛临床疗效,指导临床及时增减药量,因个体差异较大,地高辛浓度正常不能排除药物中毒的可能性,老年患者及合并用药患者是临床监测的重点。
Objective To detect digoxin plasma concentration for clinical safe, effective and reasonable use of digoxin provide a reference. Methods The data of plasma digoxin concentration monitoring in 105 patients in our hospital from March to November in 2010 were investigated. The effects of individual differences and age on plasma digoxin concentration were analyzed. Results Twenty-five patients who were below 1.0 nmol / L in the treatment range of 1.0-2.6 nmol / L had no symptoms of poisoning. Six of the 70 patients in the effective treatment range had symptoms of poisoning, Accounting for 8.57%. Seven out of 10 patients above the therapeutic range showed symptoms of poisoning, accounting for 70%. Thirteen of the 105 samples showed symptoms of poisoning, accounting for 12.38% of the monitored cases. The clinical manifestations of poisoning to arrhythmia and gastrointestinal reactions; poisoning causes in addition to individual differences in combination with medication, increased serum creatinine, hyperkalemia and so on. Conclusion The plasma concentration of digoxin can better reflect the clinical efficacy of digoxin, and guide the timely and appropriate dose increase in clinical practice. Because of the large individual differences, the normal digoxin concentration can not rule out the possibility of drug poisoning. The elderly patients and the merger Medication patients are the focus of clinical monitoring.