2种治疗药物监测结果分析

Analysis on Therapeutic Drug Monitoring of Aminophylline and Digoxine

目的:通过对治疗药物(462例地高辛、171例氨茶碱)的血药浓度监测,提出个体化给药建议,以有效指导临床合理用药。方法:用全自动微粒子化学发光免疫分析系统(EMIA)测定地高辛和氨茶碱在病人体内的血药浓度,进行血药浓度监测。结果:浓度在有效范围内比例逐年上升,低于治疗范围的比例较高,高出治疗范围的比例较低,我院共监测地高辛血药浓度462例,在有效血药浓度范围(0.8μg·L^(-1)～2μg·L^(-1))248例,有效率为53.7%;氨茶碱血药浓度171例,在有效血药浓度范围(10mg·L^(-1)～20mg·L^(-1)) 83例,有效率为48.5%。结论:该方法快速、敏感、简便,本研究提示在应用地高辛和氨茶碱等安全范围窄的药物时,应注意血药浓度监测(TDM),并密切注意患者的生理、病理、联合用药等影响因素。

Objective： To effectively instruct the rational use of medicine in the clinic by analysis of therapeutic drug monitoring （TDM） of digoxine and aminophylline and by putting forward individual dose proposal. Methods： 462 patients were given digoxine and 171 patients were given aminophylline. The blood drug levels of all the patirnts were determined by auto-microembolism chemical analyzer. Results Among the 462 patients in digoxine group, 248 patients were within effective blood drug level range（0.8μg·L^-1 -2μg·L^-1）, and the effective rate was 53.7%; among the 171 patients in aminophylline group, 83 patients were within the effective blood drug level range （10 mg·L^-1 -20 mg·L^-1）, and the effective rate was 48.5%. Conclusion： The method is rapid, sensitive and simple .It is suggested that when using the medicines with small safety range, TDM should be paid more attention to; besides, closely noticing the influencing factors such as patients＇ physiology, pathology, combined medication.