Haasis R, Salzer B, Konz K H, Ress K, Risler T, Seipel L
Dtsch Med Wochenschr. 1987 Apr 24;112(17):680-5. doi: 10.1055/s-2008-1068120.
Two hundred digitalized patients under nine freely practising physicians were investigated. One hundred and ninety-six patients received digoxin or one of its derivatives. Of these, 50% did not have therapeutic serum glycoside concentrations, 48% were in the mostly subtherapeutic range and 2% were in the potentially toxic range. Signs of glycoside intoxication were not found. A substantiated indication for glycoside therapy was found in the final analysis in 55% of the patients. In 128 patients, the methyldigoxin dose calculated (0.16 +/- 0.030 mg/d) was markedly in excess of that actually prescribed (0.13 +/- 0.050 mg/d; p less than 0.001), so that there were indications of a general underdigitalization. In addition, it was not possible to anchor the restrictive kidney function as a reason for reduction of digoxin dosage in the prescription behavior. In the long run, only 36% of the patients with justified indication and therapeutic serum glycoside concentration as well as (with reservations) the 3% with potentially toxic serum glycoside concentration profited from the glycoside therapy.
对9位执业医生负责的200例数字化患者进行了调查。196例患者接受了地高辛或其衍生物治疗。其中，50%的患者血清糖苷浓度未达到治疗水平，48%的患者大多处于亚治疗范围，2%的患者处于潜在中毒范围。未发现糖苷中毒迹象。最终分析发现，55%的患者有使用糖苷治疗的充分指征。在128例患者中，计算得出的甲地高辛剂量（0.16±0.030mg/d）明显超过实际处方剂量（0.13±0.050mg/d；p<0.001），因此有普遍用药不足的迹象。此外，在处方行为中，无法将限制性肾功能作为减少地高辛剂量的原因。从长远来看，只有36%有合理指征且血清糖苷浓度达到治疗水平的患者以及（有保留地）3%血清糖苷浓度潜在中毒的患者从糖苷治疗中获益。
