高海拔地区心衰患者地高辛浓度的测定

DETECTION OF THE DIGOXIN′S CONCENTRATION IN PATIENTS WITH HEART FAILURE AT PLATEAU

目的 :探讨高海拔地区心力衰竭患者血中地高辛浓度的变化 ;方法 :各种器质性心脏病伴心功能Ⅳ级 (心力衰竭Ⅲ )患者 2 3例 ,口服地高辛片 0 .2 5mg ,每日一次 ,连续服用 4周 ,测定其血液中地高辛的浓度 ,并观察临床表现及心电图改变 ;结果 :2 3例中地高辛血液浓度超过 2ng/ml(含 2ng/ml)者 7例 ,(1 .5～ 1 .9)ng/ml者 1 0例 ,(1 .0～ 1 .4)ng/ml者 5例 ,<1 .0ng/ml者 1例 ,其中显效 1 4例 ,有效 4例 ,无效 2例 ,出现洋地黄中毒表现者 3例 ;结论 :高海拔地区的患者易受环境、气候等多种因素的影响 ,故更应注意地高辛剂量的个体化。

Objective: To explore the changes of the digoxin's concentration in patients with heart failure at plateau (2 260m). Methods: The 23 cases of patients with various organic heart diseases showing cardiac function Ⅳ degree ( heart failure Ⅲ°)were selected randomly. Given digoxin tablets, 0.25mg once a day for 4 weeks, then we detected the serum concentration of digoxin and observed clinical manifestation and ECG in the patients. Result: The concentration of digoxin>2ng/ml (including 2ng/ml) was 7 cases; 1.5ng/ml～1.9ng/ml 10 cases; 1.0ng/ml～1.4ng/ml 5 cases and <1.0ng/ml 1 cases respectively in all the 23 cases of patients. The results also indicated 14 cases obviously effective; 4 cases effective; 2 cases ineffective and 3 cases poisoned in 23 cases of patients. Conclusion: The patients are easy to be influenced by many factors including the environment and weather at plateau, so it should be noticed the individualization of the digoxin's dosage.