Chillet P, Korach J M, Petitpas D, Vincent N, Poiron L, Barbier B, Boazis M, Berger P H
Intensive Care Unit, Centre Hospitalier de Châlons en Champagne, France.
Int J Artif Organs. 2002 Jun;25(6):538-41. doi: 10.1177/039139880202500608.
Digoxin-specific antibodies (Fab) are currently the treatment of choice for digoxin intoxication. These fragments bind to digoxin, leading to Fab-digoxin complexes, and promote the release of receptor-bound digoxin. These complexes are renally excreted. In the case of anuria, they could be dissociated and lead to renewed intoxication. In this case plasma exchanges are proposed. We report the case of an anuric patient with digoxin intoxication, treated with a Fab injection, followed by a plasma exchange 16 hours later, a second Fab injection was given followed by two plasma exchanges, 38 and 86 hours later. The disappearance of cardiac abnormalities showed the efficiency of the Fab, the drop in serum digoxin concentration and the high digoxin concentration in the exchanged plasma indicate effective elimination. The association of Fab and plasma exchanges could be proposed in the case of digoxin intoxication in the anuric patient.
地高辛特异性抗体（Fab）目前是地高辛中毒的首选治疗方法。这些片段与地高辛结合，形成Fab - 地高辛复合物，并促进与受体结合的地高辛释放。这些复合物经肾脏排泄。在无尿的情况下，它们可能会解离并导致再次中毒。在这种情况下，建议进行血浆置换。我们报告了一例无尿的地高辛中毒患者，先给予Fab注射治疗，16小时后进行血浆置换，随后再次给予Fab注射，38小时和86小时后又分别进行了两次血浆置换。心脏异常的消失表明Fab治疗有效，血清地高辛浓度下降以及置换血浆中地高辛浓度升高表明清除有效。对于无尿的地高辛中毒患者，可考虑联合使用Fab和血浆置换。
