老年患者血清地高辛浓度与地高辛中毒临床表现及相关因素分析

目的:探讨老年患者地高辛中毒症状的临床特点。方法:收集诊断为地高辛中毒的老年患者80例,对其临床资料进行回顾性分析研究。结果:80例患者中CDGX为(3.40±1.05)ng/mL,血Cr(187.5±110)μmol/L,133μmol/L 27人;BUN(16.5±9.2)mmol/L,大于7.1mmol/L者20人;血清钾(4.3±0.95)mmol/L,大于5.5mmol/L者15例;合并应用已知并能使CDGX升高药物者18人,其中1种12例,2种3例,3种以及3种以上3例。在出现地高辛中毒症状的患者中,胃肠道反应46例,头痛16例,视力模糊18例;心电图检查:室性早搏32例,房颤35例,交界性逸搏心律13例。结论:地高辛中毒的原因和表现有很多种,表现为多因素性,因此在使用地高辛时,应对患者的生理、心理和病理等方面进行详细的了解和分析。尤其是老年地高辛中毒患者,其临床症状表现不典型,跟肝、肾功能不全以及合并用药等多种因素息息相关。因此,应及时调整用药浓度,分析并制定最佳用药方案。

Analysis on the Clinical Features of Serum Digoxin Concentration and Digoxin Poisoning of Elderly Patients and the Related Factors

Objective：The clinical features of the digoxin poisoning symptoms of elderly patients are discussed, and then a correlation analysis is made to the reasons for the poisoning according to collected clinical data. Methods ： 80 elderly diagnosed with digoxin poisoning receiving in the First People＇s Hospital of Zhaoqing in 2008--2012 were collected, and their clinical data was retrospectively analyzed and studied. Results：Among 80 cases, 27 cases were with blood Cr of 133umol/L （reference value：CDGX （3.40 ±1.05） ng/mL; blood Cr （ 187.5 ±110） umol/L） ; 20 cases were with BUN higher than 7.1 mmol/L （ reference value ： BUN （ 16.5±9.2 ） retool/L） ; 15 cases were with serum potassium higher than 5.5mmol/L （reference value：serum potassium （4.3 ± 0.95） mmol/L） ; merged applications made the CDGX of 18 drug use cases increased, among which 1 drug was used for 12 cases, 2 drugs were used for 3 cases, and 3 or more drugs were used for 3 cases. Among the cases with digoxin poisoning symptoms, 46 cases had gastrointestinal reaction; 16 cases had headache; 18 eases had blurred vision. From the electrocardiogram, 32 cases had ventrieular premature beat; 35 cases were with atrial fibrillation; 13 cases had junctional escape rhythm. Conclusion： There are many reasons and features for digoxin poisoning, which can be presented with multiple factors, and therefore it is necessary to make detailed analyses on physi- ological, psychological and pathological factors of patients in using digoxin. Especially in the elderly with digoxin poisoning, their clinical symptoms are not typical, and have a connection with multiple factors such as liver and renal insufficiencies and combined medication. Therefore, it is necessary to timely adjust drug concentration, and analyze and formulate the best drug use solutions.