Halkin H, Kleiner A, Saginer A, Almog S, Millman P, Tirosh M
Isr J Med Sci. 1979 Jun;15(6):490-3.
The association between steady-state serum digoxin concentrations and control of ventricular response rate (VRR) was studied in 53 consecutive patients with atrial fibrillation. Decreases in VRR were significantly correlated with serum digoxin (rs = -0.22, P less than 0.05). Clinical responses were appropriate to serum digoxin concentrations in 37 patients (69.8%) and were inappropriate in 16 (30.2%) (P less than 0.05). Complicating clinical factors were present in all eight patients with inappropriate responses to therapeutic serum digoxin (0.5 to 2.0 ng/ml) (P = 0.046), but were also found in many patients with appropriate responses and thus could not serve to differentiate between the two categories. Digitalis intoxication occurred in one of the three patients with a concentration of serum digoxin greater than 2 ng/ml (P = 0.056). In 30% of our patients with atrial fibrillation, monitoring of serum digoxin was of value in identifying inappropriate therapeutic responses indistinguishable by clinical means and in defining the subgroup of refractory cases, which allows the prevention of digitalis intoxication.
对53例连续的房颤患者研究了稳态血清地高辛浓度与心室反应率（VRR）控制之间的关联。VRR的降低与血清地高辛显著相关（rs = -0.22，P < 0.05）。37例患者（69.8%）的临床反应与血清地高辛浓度相符，16例（30.2%）不相符（P < 0.05）。所有8例对治疗性血清地高辛浓度（0.5至2.0 ng/ml）反应不恰当的患者均存在复杂的临床因素（P = 0.046），但在许多反应恰当的患者中也发现了这些因素，因此无法用于区分这两类患者。血清地高辛浓度大于2 ng/ml的3例患者中有1例发生洋地黄中毒（P = 0.056）。在我们30%的房颤患者中，监测血清地高辛对于识别临床手段无法区分的不恰当治疗反应以及确定难治性病例亚组有价值，这有助于预防洋地黄中毒。
