地高辛血药浓度监测在ICU的临床应用与研究

Clinical application and investigation of the serum digoxin concentration monitoring in ICU

目的总结并分析我院重症监护室患者进行地高辛血药浓度监测的情况,为临床合理用药提供参考。方法采用荧光偏振免疫法测定地高辛血药浓度,利用有关统计学方法对所得数据进行处理,并作回顾性分析。结果74份病历共进行TDM 104次,其中测定地高辛46例次,达有效血药浓度34例,占73.91%;未达有效血药浓度5次,占10.87%;达中毒血药浓度7例,占15.22%。结论ICU患者基础疾病复杂,内环境紊乱,联合使用多种药物。所以使用地高辛时,剂量不能完全决定血药浓度,血药浓度也不能完全决定临床疗效,因此必须在参考TDM结果的同时,结合患者具体生理、病理及临床表现等各种情况来调整给药方案。

OBJECTIVE To evaluate the state of serum digoxin monitoring in our ICU, and to give some information for rational administration of medication in clinic. METHODS Serum digoxin concentration were determined by FPIA. Statistics and retrospect to TDM data in our ICU were carried out. RESULTS We colleted total 104 cases （74 subjects）in this paper. 46 points were monitored the serum concentration of digoxin. In this 46 points ,34 points were located at the range on effective concentration, account for 73.91% ;5 points were lower the range of effective concentration account for 10.87%; and 7 points were up to toxic blood concentraion,account for 15.22%. CONCLUSION The result showed that the dosage couldnt to toxic blood concentration, account for 15.22% conclude the serum digoxin concentration completely, and the serum digoxin concentration also couldnt conclude the clinical affection completely in ICU because that the patients in ICU usually had complicated illness and taken some other kinds of medicine at the same time. So it was very important and necessary to have individual administration of themselves with TDM and clinical experience to- gether.