地高辛血药浓度监测505例结果分析

目的为临床安全、有效、合理使用地高辛提供参考依据。方法采用荧光偏振免疫法测定地高辛血药浓度，对监测的结果进行统计分析。结果在监测的505例使用地高辛的病例中，血药浓度〈0．5μg·L^-1的有91例（18．0％），有1例（1．1％）出现中毒症状；在有效浓度范围内0．5～2．0μg·L^-1的有338例（66．9％），出现中毒症状有5例（1．5％）；血药浓度〉2．0μg·L^-1的患者有51例（10．1％），出现中毒症状有29例（56．9％）。在〉60岁的年龄组中，随患者年龄增大，血药浓度〈0．5μg·L^-1和大于2．0μg·L^-1的构成比呈上升趋势。中毒的临床表现以消化道反应（74．3％）和心律失常（31．4％）为主，中毒原因有合并用药、不同疾病等。结论及时监测地高辛血药浓度，对制定个体化给药方案，确保临床疗效，减少毒性反应的发生，具有十分重要的意义。

Blood drug level of digoxin:monitoring results of 505 cases

Aim To provide reference for clinical safe,effective and reasonable use of digoxin.Methods The blood drug level of digoxin was determined by fluorescence polarization immunization,and the monitoring results were subjected to statistical analysis.Results Of the total 505 cases who treated with digoxin,the blood drug level in 91 cases(18.0%) were under 0.5 μg·L-1,with 1case(1.1%)having symptoms of poisoning,338 cases(66.9%) between 0.5 and 2.0 μg·L-1,with 5 cases(1.5%)had symptoms of poisoning,51 cases(10.1%) higher than 2.0 μg·L-1,with 29 cases(56.9%) having symptoms of poisoning.Among the age groups older than 60 years,with the patients’age increase,the constituent ratio of the blood drug level lower than 0.5 μg·L-1 and higher than 2.0 μg·L-1 shows a rising trend.The clinical manifestations of poisoning are mainly gastrointestinal reactions(74.3%) and arrhythmias(31.4%).The causes of poisoning are combined medication,different diseases,etc.Conclusion To ensure clinical efficacy and reduce incidence of toxic reactions,it is of great importance to monitior the blood drug level and formulate individual dosage regimen.