心力衰竭患者地高辛血药浓度监测及分析

Digoxin Blood Drugs Concentration Monitoring and Analysis of Patients with Heart Failure

目的研究并探讨分析对心力衰竭患者运用强心苷类的地高辛进行治疗时的血药浓度实施监测的效果。方法对2016年1月—2018年1月在该医院服用地高辛治疗心力衰竭的100例患者的临床资料进行回顾性分析和研究。对这100例患者均使用地高辛进行为期1个星期的治疗,在用药期间对其血药浓度进行一定程度的监测。然后,观察这些患者在用药的1个星期内其血药浓度和他们中毒的发生率。结果在这100例患者中,有75例患者的血药浓度被控制在0.5~2.0 ng/mL,占总体的75.00%。这100例患者药物中毒的概率为15.00%,其中血药浓度高于2.0 ng/mL的患者药物中毒发生率为81.82%。患者体内地高辛的血药浓度越高,中毒发生率越大,差异有统计学意义(χ~2=44.721, P=0.01<0.05)。地高辛的使用量为0.25 mg/d的心衰患者中毒的发生率为27.78%,地高辛的使用量为0.125 mg/d的心衰病人中毒的发生率为6.52%,差异有统计学意义(χ~2=7.214, P=0.02<0.05)。结论对服用地高辛进行治疗的心衰患者的血药浓度进行相关的检测的效果显著,可在临床上为心衰患者安全用药提供参考。

Objective To investigate the monitoring effect of blood drug of cardiac glycosides digoxin for patients with heart failure. Methods 100 cases of patients with heart failure in our hospital from January 2016 to January 2018 were selected and treated for 1 week, during the medication, the blood drug concentration was for monitoring to a certain degree, and then the blood drug concentration and incidence rate of poisoning in 1 week of these patients were observed.Results Of 100 cases, the blood drug concentration of 75 cases was controlled between 0.5 to 2.0 ng/mL, accounting for75.00%, and the probability of drug poisoning of 100 cases reached 15.00%, and the incidence rate of poisoning of patients whose blood drug concentration was more than 2.0 ng/mL was 81.82%, the higher the blood drug concentration,the higher the incidence rate of poisoning, and the difference was statistically significant（χ2=44.721, P=0.010.05）,and the incidence rate of poisoning of patients with heart failure whose dosage of digoxin was 0.25 mg/d and patients whose dosage of digoxin was 0.125 mg/d was respectively 27.78% and 6.52%, and the differences were obvious, with statistical significance（χ2=7.214, P=0.020.05）. Conclusion The effect of blood drug concentration test of heart failure patients taking the degoxin is obvious, which can provide reference for the safe medication of heart failure patients.