摘要
目的研究患者口服芪苈强心胶囊对酶放大免疫法(EMIT)测定地高辛血药浓度的影响,为临床安全、有效、合理使用芪苈强心胶囊、地高辛以及开展相关治疗药物监测(TDM)提供参考。方法收集90例使用芪苈强心胶囊、地高辛或两者联合应用的住院患者,应用EMIT法测定血浆中地高辛浓度,进行统计分析,并建立超快速液相色谱-串联质谱(UFLC-MS/MS)测定体内地高辛药物浓度的分析方法,测定单用芪苈强心胶囊患者血浆中及芪苈强心胶囊溶液中地高辛浓度,并与EMIT法测定的结果相比较。结果 EMIT法在单用芪苈强心胶囊的患者血浆中测到地高辛阳性结果。芪苈强心胶囊联合地高辛应用组、单用芪苈强心胶囊组的EMIT法检测结果与单用地高辛组的患者相比均有升高,且差异具有统计学意义(P <0.05)。但应用UFLCMS/MS法均未从单独服用芪苈强心胶囊的患者体内及芪苈强心胶囊溶液中检测到地高辛,芪苈强心胶囊溶液的EMIT法检测结果为阳性,且结果与浓度呈线性相关。结论口服芪苈强心胶囊会对EMIT法测定地高辛血药浓度造成干扰,且影响程度可能与服用剂量相关。临床应当充分考虑芪苈强心胶囊对常规地高辛血药浓度的影响,密切关注患者的疾病进程、临床反应以及合并用药等因素,力求制订合理的个体化给药方案。
Objective To determine the effect of oral Qili Qiangxin capsules on the therapeutic drug monitoring(TDM) of digoxin blood concentration detected by enzyme multiplied immunoassay technique(EMIT) method to provide a reference for the safe use of Qili Qiangxin capsules, digoxin and related TDM. Methods Data of 90 patients were collected who took Qili Qiangxin capsules, digoxin or both. Digoxin concentration in the plasma was determined by EMIT and statistically analyzed. The concentration of digoxin was determined by UFLC-MS/MS. We also determined the digoxin concentration in the plasma of patients taking Qili Qiangxin capsules alone and in the Qili Qiangxin solution, and compared with the results by EMIT. Results EMIT used in Qili Qiangxin capsule group showed a digoxin positive result. Compared with the digoxin alone group, EMIT results in both the Qili Qiangxin capsule group and the combination group increased, with significant difference(P < 0.05). The UFLC-MS/MS method failed to detect digoxin among patients taking Qili Qiangxin capsules alone and in Qili Qiangxin capsule solution, but determination of Qili Qiangxin capsule solution was positive by EMIT and the result was linearly related to the concentration. Conclusion Qili Qiangxin capsules may lead to false positive increase of serum digoxin concentration, and the degree of influence may be related to the taken dose. The effect of Qili Qiangxin capsules on serum digoxin concentration should be fully taken into account especially when used together. Attention should also be paid to the course of disease, physiological factors and drug combinations, to develop proper individualized administration.
作者
晏林
王晶晶
姚勤
王茜
杨丽
王重娟
朱着
何燕
梁月琴
李仲昆
YAN Lin;WANG Jing-jing;YAO Qin;WANG Xi;YANG Li;WANG Chong-juan;ZHU Zhuo;HE Yan;LIANG Yue-qin;LI Zhong-kun(Department of Pharmacy,Kunming Yan'an Hospital,Kunming 650051;Department of Clinical Pharmacy,First Affiliated Hospital of Kunming Medical University,Kunming 650032;Department of Geriatrics,Kunming Yan'an Hospital,Kunming 650051)
出处
《中南药学》
CAS
2019年第11期1842-1846,共5页
Central South Pharmacy
基金
云南省高层次卫生技术人才培养专项经费资助(No.L-201614,L-201625,H-2017050)
昆明市卫生科技内设研究机构项目(No.2016SWJG)
