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1例63岁男性患者因慢性心功能不全致劳累后气喘、夜间睡眠时憋气,口服地高辛0.125 mg,1次/d。用药5 d后症状缓解,患者自行将地高辛剂量增至0.5 mg,2次/d,连续服用7 d后气喘症状较前加重,夜间睡眠不能平卧,乏力,食欲差,恶心、呕吐。心电图检查:Ⅲ度房室传导阻滞,频发室性期前收缩,呈二联律,心室率57次/min。实验室检查示血钾2.9 mmol/L;地高辛血清浓度>5.0μg/L。停用地高辛,并给予补钾等对症处理。5 d后患者症状明显缓解,心电图及血钾水平恢复正常,再次给予地高辛0.125 mg,1次/d口服。5 d后实验室检查示血钾4.2 mmol/L,地高辛血清浓度1.8μg/L,患者未再出现恶心、呕吐等不适症状。
A 63-year-old male patient with asthma due to chronic heart failure after exhaustion asthma, breath at night sleep, oral digoxin 0.125 mg, 1 / d. After 5 days of treatment, the symptoms were relieved. The patient’s own dose of digoxin was increased to 0.5 mg twice daily for 7 days. The symptoms of asthma were aggravated compared with those before treatment. Nighttime sleep was not supine, weakness, poor appetite, nausea and vomiting. ECG: Ⅲ degree atrioventricular block, frequent ventricular contraction, was bicommunal law, ventricular rate 57 beats / min. Laboratory tests showed potassium 2.9 mmol / L; digoxin serum concentration> 5.0 μg / L. Disable digoxin, and give symptomatic treatment such as potassium. After 5 days, the symptoms of patients were relieved. The electrocardiogram and blood potassium levels returned to normal. Digoxin 0.125 mg was given once a day for oral administration. Laboratory tests showed serum potassium 4.2 mmol / L and digoxin serum concentration 1.8 μg / L after 5 days. Nausea, vomiting and other symptoms did not recur.