结合676例血药浓度监测结果探讨地高辛的合理应用

Investigation and Analysis of Digoxin Serum Concentration Monitoring

目的：通过对391例患者676例次血清地高辛浓度监测，结合患者的临床资料，统计分析疗效以及不良反应，为临床合理应用地高辛提供依据。方法：收集某三甲医院2012年391例住院患者676例次地高辛血药浓度的监测结果．分析血清地高辛浓度和血清肌酐水平、以及联合用药等因素的关系，并汇总分析不良反应发生情况。结果：676例次地高辛血药浓度的监测结果中，396例次（占58．58％）在有效血药浓度范围0．8～2．0ng／mL．111例次（占16．42％）低于治疗浓度范围下限〈0．8ng／mL，169例次（占25％）高于治疗浓度上限），2．0ng／mL．不良反应发生率为13．91％。结论：应加强对地高辛临床治疗浓度的监测，根据血药浓度调整给药剂量．实现个体化给药，从而提高疗效及降低毒性发生率．促进地高辛在临床的合理使用。

Objective： To analyze digoxin serum concentrations in 676 cases of 391 patients and provide a reference for digoxin individual therapy. Methods： A retrospective analysis of digoxin serum concentrations was conducted, studying the relation between digoxin concentrations, serum creatinine, drug combination, and the incidence of adverse reactions. Results： Of 676 cases, 396 cases （58.58%）had appropriate digoxin serum concentrations within the effective therapeutic concentration of 0.8-2.0ng/mL, and 111 cases （16.42%）had lower digoxin serum concentrations below 0.8ng/mL, and 168 cases （24.85%）had higher digoxin serum above 2.0ng/mL. The incidence rate of adverse reaction was 13.91%. Conclusion： Concentration monitoring of digoxin should be strengthened, in order to make individualized dosing regimens for patients.