摘要
目的:了解空军总医院老年住院患者近十年来使用地高辛的情况,为下一步深入开展地高辛个体化给药方法提供参考依据。方法:收集空军总医院1999~2008年300例应用地高辛的老年患者病历资料,利用构成比和百分比进行统计分析。结果:地高辛治疗心血管系统疾病中,居前4位的依次为冠心病、高血压病、心房颤动、风湿性心脏病。给药方案中缓给法有242例,构成比占80.7%;先用西地兰D后用地高辛的序贯给药法的有58例,占19.3%。联合使用的药物中,居前4位的是排钾利尿剂、抗生素、螺内酯和钙通道阻滞剂。血药浓度监测值低于0.5μg.L-1的有63人,占21.0%(63/300);在治疗窗0.5~1.5μg.L-1范围内的有163人,占54.3%(163/300);高于1.5μg.L-1的有74人,占24.6%(74/300),其中31人出现不同程度的中毒反应,占10.3%(31/300)。在上述不同浓度范围内,>80岁和肾功能不正常的人群所占构成比例逐步升高。结论:老年人群(尤其>80岁的)病情复杂,肾功能低下,联合用药多,使用地高辛时应加强监测,进行个体化给药。
OBJECTIVE： To analyze the utilization of digoxin in old patients in Air Force General Hospital of PLA in recent 10 years to provide reference for developing individual dosage regimes.METHODS： The medical records of 300 old patients taking digoxin orally in Air Force General Hospital of PLA from 1999 to 2008 were statistically analyzed in respect of the constituent ratio and percentage.RESULTS： Of all the cardiovascular diseases treated by digoxin,dominating the first 4 places were coronary heart disease,hypertensive disease,atrial fibrillation and rheumatic heart disease.In terms of dosage regimen of digoxin,bradyadminatration was performed in 242 cases（80.7%）;and sequential administration of initial cedilanid D followed by digoxin in 58（19.3%）.Of the drugs used in combination,leading the first 4 places were potassium-removing diuretics,antibiotics,spironolactone and calcium channel blockers.The serum digoxin concentrations were lower than 0.5 μg·L^（-1） in 21.0%（63/300）,which were within therapeutic window range of 0.5~1.5 μg·L^（-1） in 54.3%（163/300）,and 24.6%（74/300） had a therapeutic window range of higher than 1.5 μg·L^（-1）.Toxic reactions of different degree occurred in 10.3%（31/300）.Within the above concentration ranges,the patients aged over 80 years or those with renal dysfunction took a higher proportion.CONCLUSION： The application of digoxin should be monitored and individualized in older patients especially those aged over 80 years on account of their complicated conditions,renal hypofunction and concomitant use of multiple drugs.
出处
《中国医院用药评价与分析》
2010年第1期13-15,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
全军"十一五"自然科学基金资助项目(06MA024)
关键词
地高辛
用药分析
合理用药
Digoxin
Analysis of drug use
Rational use of drug
