78例地高辛中毒的临床特点及相关因素分析

Clinical Characteristics and Related Factors of Digoxin Intoxication in 78 Cases

目的探讨地高辛中毒患者的临床特点,为临床合理用药提供参考。方法结合国内外文献,回顾性分析78例地高辛中毒患者的临床资料。结果 78例患者中,男23例,女55例;平均年龄(77.43±8.3)岁。56例患者出现了消化道不良反应,10例产生了中枢神经系统症状,63例有不同类型的心律失常,18例伴肾功能减退,25例伴低血钾;89.74%的患者血清地高辛质量浓度大于2.0 ng/mL。结论地高辛中毒常见的临床表现有消化道症状、神经精神症状及心律失常;地高辛中毒相关因素包括年龄、性别、药物剂量、电解质水平、肾功能等;使用地高辛主张采用小剂量维持疗法,注意剂量个体化,密切观察有无中毒先兆,及时监测血药浓度,以有效减少或避免中毒的发生。

Objective To investigate the clinical characteristics of patients with Digoxin intoxication and provide references for clinical rational drug use. Methods The clinical data of 78 patients with Digoxin intoxication was retrospectively analyzed combined with do- mestic and foreign literature. Results The average age of 78 patients was （77.43 ＋ 8.3）years old, including 23 cases of male and 55 cases of female. 56 patients appeared gastrointestinal reaction, 10 patients had central nervous system symptoms,and there were different types of arrhythmia in 63 patients, 18 patients were accompanied with renal hypofunction and 25 patients had hypokalemia. The serum Digoxin concentration was greater than 2.0 ng/mL in 89.74% of the poisoning patients. Conclusion The common clinical manifes-tations of Digoxin intoxication included gastrointestinal symptoms, neuropsychiatric symptoms and arrhythmias. The related factors of Digoxin intoxication included age,sex,titus dosage,electrolyte,renal function,etc. The use of Digoxin with low- dose maintenance therapy should be adopted. We should pay attention to the dose individualization, closely observe any toxic precursor and timely monitor the blood drug concentration,in order to effectively reduce or avoid the occurrence of poisoning.