结合676例血药浓度监测结果探讨地高辛的合理应用

摘要

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.%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。