地高辛治疗窗浓度的再探讨

Discussion on Therapeutic Window Concentration of Digoxin

目的:探讨地高辛治疗慢性心力衰竭的血清治疗窗浓度范围。方法:将心力衰竭患者随机分成小剂量组和常规剂量组,分别给予小剂量和常规剂量地高辛治疗,采用荧光偏振免疫法测定地高辛血药浓度。结果:小剂量组有效率、无效率、中毒率分别为71.9%、21.9%、6.3%,常规剂量组分别为64.7%、19.1%、16.2%,2组有效率、无效率均无显著性差异(P>0.05),中毒率小剂量组显著低于常规剂量组(P<0.05);小剂量组地高辛有效、无效、中毒浓度分别为(0.87±0.41)、(0.67±0.34)、(1.70±0.48)μg/L,常规剂量组分别为(1.11±0.48)、(0.71±0.39)、(1.69±0.63)μg/L,2组地高辛无效浓度、中毒浓度均无显著性差异(P>0.05),地高辛有效浓度小剂量组显著低于常规剂量组(P<0.01)。结论:地高辛治疗慢性心力衰竭的血清治疗窗浓度范围以0.50～1.50μg/L为宜。

OBJECTIVE:To study the therapeutic window concentration range of serum digoxin in the treatment of chronic cardiac failure.METHODS:Patients with chronic cardiac failure were divided into small dose group and routine dose group,and administered respectively with low dose digoxin and routine dose digoxin,the serum digoxin concentrations in patients were determined by FPIA.RESULTS:The effective rate,invalid rate and toxication rates of the low dose digoxin group were71.9%,21.9%and6.3%respectively,those for the routine dose digoxin group were64.7%,19.1%and16.2%reˉspectively,no significant differences were found in effective rates and the invalid rates between2groups(P>0.05),the toxiˉcation rate of the low dose group was lower than that of the routine group(P<0.05);The effective concentration range,invalid concentration range and the toxic concentration range of low dose digoxin group were(0.87±0.41),(0.67±0.34)and(1.70±0.48)μg/L respectively,and those for the routine group were(1.11±0.48),(0.71±0.39)and(1.69±0.63)μg/L respectively,no significant differences were found in the invalid concentration and the toxication concentration between the two groups(P>0.05),the effective concentration of the low dose digoxin group was significantly lower than the routine group(P<0.01).CONCLUSION:It is advisable to regulate the therapeutic window concentration of digoxin within the range of(0.5～1.50)μg/L in the treatment of chronic cardiac failure.