Bayesian一点法研究心衰患者的地高辛临床药物动力学及给药方案

Study on clinical pharmacokinetics and dosage regimens of digoxin by one-point Bayesian approach

本文用放免分析法测定血药农度。用Ｂａｙｅｓｉａｎ—点法研究３４例心衰患者的地高辛临床药动学，参数为：消除半衰期（Ｔ１／２）６０．８±１２．２ｈ，消除速度常数（ｋ）０．０１１９±０．００２３ｈ－１，分布容积（Ｖｄ）７．５±１．１Ｌ／ｋｇ，清除率（ＣＬ）８９．７±２０．９ｍｌ·ｈ－１．ｋｇ－１。显示患者个体存在较大差异。按Ｂａｙｅｓｉａｎ个体参数计算给药方案，所有患者的血药浓度始终维持在０．８～２．０ｎｇ／ｍｌ有效范围内。数据分析表明，在缺乏监测的条件下，可根据患者的血清肌酐水平作出剂量判断，Ｃｒ≤９０μｍｏｌ／Ｌ为０．２５ｍｇｑｄ，Ｃｒ＞９０μｍｏｌ／Ｌ为０．１２５ｍｇｑｄ。

adioimmunoassay was used to measure serum digoxin concentration. The clinical pharmacokinetics of digxin was studiedin 34 patients with congestive heart failure by one-point Bayesian approach,The pharmacokinetic parameters were t = 60.8+12.2h,k=0. 0119+0.0023h,Vs=7.5+1.1L/kg,CL=89.7±20. 9ml.h-1.kg. The results showed that the indivedu-al pharmacokinetic parameters of the patienes were discrepant. The regimen computed by Bayesian individual parameters,gavesatisfactory results. The serurn digoxin concentrations of all patients were in 0.8～0.2ng/ml in accordance with digoxin thera-peutic reference range. The data Of analysis showed that the regimen could be established according to the serum creatinine lev-el of the patients when there is no means mornitoring digoxin level. The digoxin dosage regimen was 0.25 mg q.d,when theserum creatinine level was lower than 90μmol/L, it wzas 0.125mg q.d.when the serum creatinine level was higher than 90μmo1/L.