CAJ | 학술논문

目的：研究充血性心力衰竭病人地高辛(DG)临床药动学及影响因素。方法：用RIA法测定DG血药浓度。用Bayesian一点法拟合DG个体药动学参数及给药方案。用Minitab软件进行统计学分析。结果：CrCl为(54.2±18.2)mlmin-1，Cl为(73.4±27.5)mlh-1kg-1，Vd为(6.95±1.07)Lkg-1，t1/2为(73.7±23.5)h，K为(0.010 4±0.003 3)h-1；各参数波动范围大，变异均在30%以上(Vd除外)。年龄与CrCl，Cl和Vd存在极显著性负相关(P＜0.001)，CrCl与Cl，Vd存在高度的正相关(P＜0.001)，尤其是Vd，r=0.913。不同年龄段CHF患者的CrCl较正常人减少约25 mlmin-1。结论：随着年龄的增长，肾功能逐渐下降，DG的Cl和Vd也随之相应减少。CrCl和Vd的高相关性与心功能不全累及肾功能损害和外周血管的慢性收缩有关，使DG分布和排泄发生障碍。CHF患者的肾损害也随心功能恶化而加剧。
목적：연구충혈성심력쇠갈병인지고신(DG)림상약동학급영향인소。방법：용RIA법측정DG혈약농도。용Bayesian일점법의합DG개체약동학삼수급급약방안。용Minitab연건진행통계학분석。결과：CrCl위(54.2±18.2)mlmin-1，Cl위(73.4±27.5)mlh-1kg-1，Vd위(6.95±1.07)Lkg-1，t1/2위(73.7±23.5)h，K위(0.010 4±0.003 3)h-1；각삼수파동범위대，변이균재30%이상(Vd제외)。년령여CrCl，Cl화Vd존재겁현저성부상관(P＜0.001)，CrCl여Cl，Vd존재고도적정상관(P＜0.001)，우기시Vd，r=0.913。불동년령단CHF환자적CrCl교정상인감소약25 mlmin-1。결론：수착년령적증장，신공능축점하강，DG적Cl화Vd야수지상응감소。CrCl화Vd적고상관성여심공능불전루급신공능손해화외주혈관적만성수축유관，사DG분포화배설발생장애。CHF환자적신손해야수심공능악화이가극。
OBJECTIVE: To study clinical pharmacokinetics of digoxin and its influence factors in patients with congestive heart failure. METHOD: Radioimmunoassay was used to measure serum digoxin concentration, the method of one point of Bayesian to calculate digoxin clinical pharmacokinetics parameters as well as dosage regimens, and the minitab software to analyse data statistically. RESULTS: CrCl was (54.2±18.2)mlmin-1, Cl (73.4±27.5)mlh-1kg-1, Vd (6.95±1.07)Lkg-1, t1/2(73.7±23.5)h, K(0.010 4±0.003 3)h-1. Every parameter varied greatly, and their variations were all above 30% except Vd. There was a very significantly negative correlation between age and any of CrCl, Cl and Vd (P＜0.001), and a strong positive correlation between CrCl and Cl or Vd (P＜0.001), especially Vd (r=0.913). CrCl was approximately 25 mlmin-1 less than normal persons at different age of CHF patients. CONCLUSION: Kidney function droped gradually, Cl and Vd also lessened with age. A strong correlation of CrCl and Vd involved heart function failure, kidney function damaged and the slow contracting external blood vessels resisted the distribution and eliminaton of digoxin. Kidney function damage of CHF patients aggravated with the worsening of heart function.