地高辛血清浓度影响因素及我院合理应用情况分析

Analysis on Influence Factors of Plasma Concentration of Digoxin and Its Rational Use in Our Hospital

目的:探讨影响地高辛血清浓度(SDC)的因素及我院应用现状,为临床提高地高辛的合理应用比例提出建议。方法:收集2008～2009年我院445名住院患者581例/次服用地高辛并测定血清浓度的临床资料。分析我院目前地高辛应用的现状,应用多元逐步回归法分析年龄(Age)、性别(Gen)、科室(Dept)、合并用药(Drug)、血清肌酐浓度(Scr)、服药剂量(Dose)与SDC的关系。结果:Age、Gen、Dept、Drug、Scr、Dose与SDC有相关性。结论:SDC个体差异较大,影响因素较多。调查中16.2%服用地高辛患者出现不良反应,胃肠道反应最常见,对于其引起的心律失常不良反应应该引起足够的重视。我院外科住院患者SDC相对内科患者高(P<0.05)。对于大多数患者而言,每日用药剂量不宜>0.125mg。老年女性患者应用地高辛尤应注意用药剂量,及时监测。药师在地高辛的合理用药中应发挥更多的作用。

OBJECTIVE：To investigate the influence factors of plasma concentration of digoxin（SDC）and application of it in our hospital in order to promote rational use of digoxin. METHODS：445 cases treated with digoxin were collected from our hospital and plasma concentration of digoxin was detected. Multiple stepwise regressions were used to analyze current application of digoxin,relationship between SDC and factors including age,gender（Gen）,departments（Dept）,drug combination（Drug）,serum creatinine concentration（SCR）,dose. RESULTS：SDC was relation with age,gender（Gen）,departments（Dept）,drug combination（Drug）,serum creatinine concentration（SCR）,dose. CONCLUSION：There are many influence factors of SDC which are different among individual patients. In our survey,16.2% patients taking digoxin occurs adverse reactions. The most common adverse reaction is nausea and poor appetite. We should pay attention to arrhythmia caused by digoxin. The SDC of surgical inpatients were higher than that of medical inpatients（P0.05）. For most patients,daily dose of digoxin should be lower than 0.125 mg. Elderly female patients taking digoxin should care dosage and to be monitored timely. Pharmacist should play a greater role in the application of digoxin.