恰加斯心肌病心力衰竭患者的地高辛血清水平。

Digoxin serum levels in patients with Chagas' cardiomyopathy and heart failure.

机构信息

Department of Cardiology and Cardiovascular Surgery, Base Hospital, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, SP, Brazil.

出版信息

Rev Soc Bras Med Trop. 2010 Sep-Oct;43(5):496-9. doi: 10.1590/s0037-86822010000500004.

DOI:10.1590/s0037-86822010000500004

PMID:21085856

Abstract

INTRODUCTION

The purpose of this study was to determine digoxin serum concentrations in patients with Chagas' cardiomyopathy with chronic heart failure, because little is known concerning this laboratory test in patients with this condition.

METHODS

This study focuses on 29 (29%) out of 101 patients with chronic heart failure secondary to Chagas' cardiomyopathy receiving digoxin therapy. Digoxin was measured by the immune-enzymatic method.

RESULTS

New York Heart Association Functional Class III/IV was noted in 13 (45%) patients. The mean potassium serum level was 4.3 ± 0.5 mEq/L, mean creatinine serum levels 1.4± 0.3dg/100ml, and left ventricular ejection fraction 34.7 ± 13.8%. The median digoxin serum level was 1.27 (0.55; 1.79)ng/ml. Sixteen (55%) patients had digoxin serum levels higher than 1.0 ng/ml. Abnormal digoxin serum levels were verified in 13 (45%) patients. Digoxin serum levels correlated moderately with creatinine serum levels (r = 0.39; p < 0.03) and negatively with sodium serum levels (r= -0.38; p= 0.03).

CONCLUSIONS

Digoxin serum concentration should be measured in patients with Chagas' cardiomyopathy with chronic heart failure receiving digoxin therapy due to the potential for digoxin toxicity.

摘要

简介

本研究旨在确定慢性心力衰竭并发恰加斯心肌病患者的地高辛血清浓度，因为对此类患者的实验室检测知之甚少。

方法

本研究重点关注了 101 例接受地高辛治疗的慢性心力衰竭继发于恰加斯心肌病的患者中的 29 例（29%）。地高辛采用免疫酶法测定。

结果

13 例（45%）患者纽约心脏协会功能分级为 III/IV 级。血清钾平均水平为 4.3 ± 0.5 mEq/L，血清肌酐平均水平为 1.4± 0.3dg/100ml，左心室射血分数为 34.7 ± 13.8%。地高辛血清中位数为 1.27（0.55；1.79）ng/ml。16 例（55%）患者的地高辛血清水平高于 1.0ng/ml。13 例（45%）患者的地高辛血清水平异常。地高辛血清水平与肌酐血清水平中度相关（r = 0.39；p < 0.03），与血清钠水平呈负相关（r= -0.38；p= 0.03）。