188例次地高辛血药浓度监测分析

The analysis of serum digoxin concentration monitoring of 188 cases

目的 总结本院地高辛血药浓度监测情况,为临床提供参考。方法 对2002年188例次地高辛血药浓度监测的目的、采血时间、血药浓度结果分布、病人临床情况以及临床对本部门所提用药建议的采纳情况进行统计分析。结果 地高辛血药浓度监测目的以诊断中毒为多,占54.3％;采血时间除个别外,大多数符合要求。血药浓度结果,低于0.5ng/ml的有31例次(占16.5％);在0.5～2.0ng/ml范围内的有123例次(占65.4％);高于2.0n/ml的有34例次(占18.1％)。除少数病例外,临床疗效及毒性反应与浓度结果有较好的相关性。共提出个体化给药方案75项,有36项(占48％)被采纳。结论 进行血药浓度监测对安全有效地应用地高辛十分必要。在判断中毒或设计个体化给药方案时,需综合考虑各种因素的影响。

Purpose This paper summarized the TDM of digoxin in our hospital, it gave advice for clinical therapy. Methods The purposes,time of drawing blood,results and the clinical reaction of patients who were cured hy digoxin of 188 cases in 2002 were ana- lysed and the feedback from the doctors to our drug using advice were also summed up. Results Most purposes of digoxin concentration monitoring in serum were diagnosed as intoxication. Its rate was 54. 3%. Most of the time of drawing blood was appropriate. The concen- tration in 31 cases were under 0. 5 ng/ml; in 123 cases were between 0.5～2. 0 ng/ml; in 34 cases were higher than 2. 0 ng/ml. There was a high correlation between clinical effect, intoxication reaction and drug concentration. 75 individual medicine schemes were provid- ed and 36 cases were accepted. Conclusion It is necessary to have serum concentration monitoring that we can use digoxin safely and efficiently. No matter judging intoxication or designing individual drug scheme,all kinds of factors should be considered seriously.