Erbel R, Kraemer R, Kleesiek K, Schweizer P, Pop T, Effert S
Z Kardiol. 1979 Sep;68(8):590-8.
In two patients with suicidal digoxin poisoning the correlations between serum digoxin concentration and changes in the duration of QTc and the flattening of the T-waves were studied. The digoxin serum half-life following suicidal digoxin poisoning was in the first patient (10 mg beta-acetyl derivative of digoxin) 77 h, prolonged cause of renal insufficiency, and in the second patient 39.6 h. (20 mg beta-acetyl derivative of digoxin). In both patients the digoxin induced flattening of the T-wave reached a plateau of maximum efficacy at a serum level of 2-3 ng/ml with no further change up to a serum level of 13.2 ng/ml and 9.6 ng/ml respectively. A linear correlation, however, was found between the digoxin serum concentration and the digoxin induced shortening of QTc, r = 0.88 and r = 0.92 respectively. A plateau maximum efficacy was not found. The regression equations were y = -12.0 chi + 430.8 and y = -8.0 chi + 391.9 respectively. The shortening of QTc is therefore an important parameter for the diagnosis of digoxin poisoning. It can be determined very quick with no methodical problems.
对两名自杀性地高辛中毒患者,研究了血清地高辛浓度与QTc间期变化及T波低平之间的相关性。第一名患者(10mg地高辛β-乙酰衍生物)自杀性地高辛中毒后的地高辛血清半衰期为77小时,因肾功能不全而延长,第二名患者(20mg地高辛β-乙酰衍生物)为39.6小时。在两名患者中,地高辛引起的T波低平在血清水平为2 - 3ng/ml时达到最大效应平台期,分别在血清水平达到13.2ng/ml和9.6ng/ml时不再有进一步变化。然而,发现地高辛血清浓度与地高辛引起的QTc缩短之间存在线性相关性,r分别为0.88和0.92。未发现平台期最大效应。回归方程分别为y = -12.0x + 430.8和y = -8.0x + 391.9。因此,QTc缩短是诊断地高辛中毒的一个重要参数。它可以非常快速地测定,且不存在方法学问题。