心力衰竭患者地高辛血药浓度监测结果与临床疗效分析

Analysis of Serum Digoxin Concentration and Clinical Efficacy in Patients with Heart Failure

目的:探讨慢性心力衰竭患者地高辛血药浓度与临床疗效的关系。方法:采用荧光偏振免疫法(FPIA)测定337例地高辛血药浓度,根据地高辛血药浓度将患者分成5组,并分析其临床资料。结果:A组(<0.50ng·mL-1)患者的有效率、全因住院率、全因死亡率及中毒率分别为18.8%、27.5%、11.6%、0.0%;B组(0.50～0.90ng·mL-1)患者分别为85.3%、26.3%、13.7%0.0%;C组(0.91～1.50ng·mL-1)患者分别为87.3%、31.6%、19.0%、3.8%;D组(1.51～2.00ng·mL-1)患者分别为84.8%42.4%、24.2%、12.1%;E组(>2.00ng·mL-1)患者分别为44.3%、59.0%、36.1%、54.1%。结论:地高辛治疗慢性心力衰竭的血药浓度以0.50～0.90ng·mL-1为宜。

OBJECTIVE：To investigate the relationship between serum concentration of digoxin and clinical efficacy in patients with heart failure.METHODS：The serum concentration of digoxin in 337 patients was determined by fluorescent polarization immunoassay （ FPIA）.The patients were divided into five groups according to the serum concentration of digoxin with their clinical data analyzed.RESULTS：The effective rate,all-cause hospitalization rate,all-cause mortality rate and rate of poisoning by digoxin in group A （0.50 ng·mL-1） were 18.8% ,27.5% , 11.6% and 0.0% ,respectively,as compared with 85.3% ,26.3% ,13.7% and 0.0% ,respectively in group B （0.50-0.90 ng·mL-1）,87.3% ,31.6% ,19.0% and 3.8% ,respectively in group C （0.91-1.50 ng·mL-1）, 84.8% ,42.4% ,24.2% ,12.1% ,respectively in group D （1.51-2.00 ng·mL-1 ）,and 44.3% ,59.0% , 36.1% and 54.1% ,respectively in group E （2.00 ng·mL-1 ）.CONCLUSION：The optimal serum concentration range of digoxin is 0.50-0.90 ng·mL-1 in the treatment of chronic heart failure.