摘要
目的:探讨临床药师针对性干预措施对地高辛治疗患者血药浓度的影响。方法:将2017年6月-2018年6月采用地高辛治疗的患者分为高浓度组(血药浓度>2.0 ng/mL)与对照组(0.8 ng/mL<血药浓度≤2.0 ng/mL),分析引起地高辛血药浓度升高的主要危险因素。选取2019年7月-2020年7月使用地高辛治疗的患者160例,随机分为干预组和非干预组,各80例,均进行血药浓度监测,其中干预组针对危险因素进行干预,非干预组仅给予常规用药指导,分析两组患者血药浓度差异及地高辛中毒发生率。结果:高龄、合并肾功能障碍、联合使用β受体阻滞剂、噻嗪类利尿剂、抗凝药物为引起地高辛血药浓度水平升高的危险因素,差异有统计学意义(P<0.05)。干预组有效血药浓度范围占比高于非干预组,差异有统计学意义(P<0.05);干预组血药浓度偏高患者占比低于非干预组,差异有统计学意义(P<0.05);两组地高辛中毒发生率比较,差异无统计学意义(P>0.05)。结论:临床药师针对性干预及个体化用药指导能维持地高辛有效血药浓度,对临床合理安全使用地高辛具有积极意义。
Objective:To explore the influence of clinical pharmacists’targeted intervention measures on blood drug concentration in patients treated with digoxin.Methods:Patients treated with digoxin from June 2017 to June 2018 were divided into high concentration group(blood drug concentration>2.0 ng/mL)and control group(0.8 ng/mL<blood drug concentration≤2.0 ng/mL).The main risk factors inducing the increase of blood drug concentration of digoxin were analyzed.A total of 160patients treated with digoxin from July 2019 to July 2020 were selected and randomly divided into intervention group and nonintervention group,with 80 cases in each group.Blood drug concentration was monitored.The intervention group was given interventions for risk factors,and the non-intervention group was given general medication instruction only.The difference of blood drug concentration and the incidence of digoxin poisoning between the two groups were analyzed.Results:Advanced age,complication with renal dysfunction,combined use ofβ-receptor blockers,thiazide diuretics and anticoagulants were risk factors inducing the increase of blood drug concentration of digoxin,and the difference was statistically significant(P<0.05).The proportion of effective blood drug concentration range in the intervention group was higher than that in the non-intervention group,and the difference was statistically significant(P<0.05).The proportion of patients with high blood drug concentration in the intervention group was lower than that in the non-intervention group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of digoxin poisoning between the two groups(P>0.05).Conclusion:Clinical pharmacists’targeted intervention and individualized medication guidance can maintain the effective blood drug concentration of digoxin,and play a positive role in the rational and safe use of digoxin in clinical practice.
作者
石慧
杨博文
王金利
Shi Hui;Yang Bo-wen;Wang Jin-li(Department of Pharmacy,Huishan District People's Hospital of Wuxi,Wuxi 214187,Jiangsu Province,China)
出处
《中国社区医师》
2023年第1期15-17,共3页
Chinese Community Doctors
基金
无锡市科学技术协会软科学研究课题(编号:KX-22-B12)。
关键词
临床药师
地高辛
血药浓度
个体化用药
Clinical pharmacist
Digoxin
Blood drug concentration
Individualized medication
作者简介
通信作者:王金利。
