3026例次地高辛血药浓度监测及其影响因素分析

Analysis of the Serum Concentration of Digoxin and the Influencing Factors in 3026 Cases

目的:对我院8年来3026例次大样本地高辛血药浓度(SCD)监测结果及其相关临床资料进行回顾性分析.方法:采用荧光偏振免疫分析法(FPIA)测定SCD,分别就性别、年龄、体重、基础疾病和合并症等因素对其中0.25 mg*qd剂量下所得的2058个SCD的影响进行t检验和方差分析.结果:2058个SCD中,低于0.5 ng*mL-1有406例次;在0.5～2.0 ng*mL-1有效治疗范围内的有1311例次,但有39例出现中毒症状,占1.90%;2.0～5.0 ng*mL-1范围内的有267例次,有128例中毒,占6.22%;>5.0 ng*mL-1有35例次,全部出现中毒症状,占1.70%.结论:临床应用地高辛,约9.81%出现中毒症状,而年龄、体重及疾病状态尤其是严重疾病伴有肾功能不全或低钾血症,对SCD有显著影响(P<0.05).因此,监测SCD并结合临床资料,对指导临床合理用药有重要意义.

ve:To analyze the monitoring results of the serum concentration of digoxin(SCD) in 3026 cases and discuss the influencing factors. Methods: The SCD was detected by fluorescence polarization immunoassay,and the associate influencing factors including sex, age, body weight, clinical status were analyzed with t-test and variance analysis. Results: Among 2058 samples obtained from those with the dosage of digoxin lower than 0. 25mg qd, the SCD were lower than 0. 5 ng · mL-1 in 406 and 0. 5 - 2. 0 ng · mL-1 in 1311 , among the latter 39 cases (1. 90% )exhibited toxic symptoms. 267 cases had the SCD levels of 2. 0 - 5. 0 ng · mL-1 and 128 of them exhibited toxic symptoms(6. 22% ). 35 cases had the SCD levels higher than 5. 0 ng · mL-1 and all exhibited toxic symptoms ( 1. 70% ). Conclusion; The incidence rate of digoxin toxication was 9. 81%. The factors influencing the SCD level include age, body weight and clinical status especially severe diseases accompanied by renal malfunction or hypopotassemia. Therefore, it is very important to monitor the SCD level and pay attention to the patients clinical status when the drug is used.