地高辛血药浓度与临床疗效关系

The relationship between serum digoxin concentration and its therapeutic efficacy

目的:研究地高辛浓度与临床疗效之间的关系.方法:将353例口服地高辛的充血性心衰患者分成3组:有效组、无效组及中毒组.应用放射免疫法(RIA)对其稳态血药浓度进行测定同时观察疗效.结果;平均血药浓度有效组为(1.07±0.50)ng/ml,无效组为(0.97±0.54)ng/ml,中毒组为(2.74±1.35)ng/ml.有效组与中毒组之间血药浓度有显著性差异(P<0.001).有效组与中毒组之间单位剂量(mg·kg^(-1)·d^(-1))有显著性差异(P<0.01).有效组单位剂量为(0.004 0±0.001 2)mg·kg^(-1)·d^(-1),中毒组为(0.004 7±0.001 9)mg·kg^(-1)·d^(-1).结论:地高辛血药浓度的监测可以指导临床医生合理用药、提高疗效、避免或减少不良反应.

AIM: To study the relationship between serum digoxin concentration and therapeutic efficacy. METHODS: Three hundred and fifty-three cases were divided into 3 groups on the basis of clinical considerations. The groups were as follows :responder group, nonresponder group and toxic group. The digoxin concentration was determinated by radioimmunoassay and therapeutic efficacy was observed. RESULTS: The mean digoxin concentration in responder group, nonresponder group and toxic group were (1. 07±0. 50) , (0. 97±0. 54),(2. 74±1. 35) ng/ml respectively. There was significant difference for digox-in level between the responder and the toxic groups(P>0. 001). The mean doses in respon-der group and toxic group were (0. 004 0±0. 001 2) and (0. 004 7±0. 001 9) mg ·kg^(-1) ?d^(-1) respectively. CONCLUSION: The serum digoxin determination correlates well with the therapeutic and toxic responses of patients and serves a useful purpose in controlling digoxin therapy.