Kühn P, Hohenwallner W, Wimmer E, Sommer R
Wien Klin Wochenschr. 1980 May 9;92(10):356-60.
The purpose of the present study was the collection of data concerning digitalis treatment of patients outside hospital. The investigation was carried out on 200 patients over 60 years of age, consecutively admitted to a 750-bed general hospital (35% ot a medical ward, 65% to other specialities). An ECG and serum creatinine and digoxin determinations were performed on the day of admission and a careful history taken of the drugs administered before admission. 30 patients reported the use of digoxin or other digitalis drugs, whilst another 48 patients reported taking cardiac drugs in general. The prevalence of digoxin levels exceeding 2 ng/ml was 11.5% in the group of patients known to have taken digitalis preparations, 18% among the 92 patients with positive serum digoxin levels and highest (30%) in the subgroup admitted due to cardiac failure. In patients with digoxin levels above 2 ng/ml the prevalence of elevated serum creatinine values (greater than 1.2 mg%) was markedly increased. Among patients with normal serum creatinine levels the mean age of patients with digoxin levels above 2 ng/ml was significantly higher than of those with digoxin levels below 2 ng/ml. A clear correlation between digoxin levels and ECG changes was not demonstrable; simultaneous administration of diuretics promotes the appearance of electrocardiographic signs of digitalis toxicity.
本研究的目的是收集有关院外患者洋地黄治疗的数据。对连续入住一家拥有750张床位的综合医院的200名60岁以上患者进行了调查(35%入住内科病房,65%入住其他专科)。入院当天进行了心电图、血清肌酐和地高辛测定,并仔细询问了入院前服用的药物史。30名患者报告使用过地高辛或其他洋地黄药物,另有48名患者报告一般服用过心脏药物。在已知服用过洋地黄制剂的患者组中,地高辛水平超过2 ng/ml的患病率为11.5%,在血清地高辛水平呈阳性的92名患者中为18%,在因心力衰竭入院的亚组中最高(30%)。在地高辛水平高于2 ng/ml的患者中,血清肌酐值升高(大于1.2 mg%)的患病率明显增加。在血清肌酐水平正常的患者中,地高辛水平高于2 ng/ml的患者的平均年龄显著高于地高辛水平低于2 ng/ml的患者。地高辛水平与心电图变化之间没有明显的相关性;同时使用利尿剂会促进洋地黄毒性心电图体征的出现。