Graves S W
Crit Rev Clin Lab Sci. 1986;23(3):177-200. doi: 10.3109/10408368609165799.
Recent research has demonstrated the presence of endogenous compounds in blood and urine that crossreact with antibodies raised against digoxin. Given the widespread therapeutic use of digoxin and its being monitored clinically by immunoassay, such digoxin-like immunoreactive compounds pose significant diagnostic and interpretive problems. Serum levels of this factor(s) approaching therapeutic digoxin levels have been found in digoxin-free patients in renal failure, pregnant women, and newborns. The compound is incompletely characterized; however, existing data suggest that it is a small, neutral, nonpeptidic compound. In serum it is highly protein bound, and alterations in this binding appear to give rise to the false-positive assay results. The urinary form is probably conjugated. Digoxin-like immunoreactive substances may play a role in volume homeostasis and appear associated with essential and pregnancy-induced hypertension. If such roles are primary, measurement of digoxin-like immunoreactive substances may prove to be of value in and of itself.
最近的研究表明，血液和尿液中存在内源性化合物，它们与针对地高辛产生的抗体发生交叉反应。鉴于地高辛的广泛治疗用途以及通过免疫测定法对其进行临床监测，此类地高辛样免疫反应性化合物带来了重大的诊断和解释问题。在肾衰竭的无地高辛患者、孕妇和新生儿中，已发现该因子的血清水平接近地高辛治疗水平。该化合物的特性尚未完全明确；然而，现有数据表明它是一种小分子、中性、非肽类化合物。在血清中，它与蛋白质高度结合，这种结合的改变似乎会导致检测结果出现假阳性。其尿液形式可能是结合型的。地高辛样免疫反应性物质可能在容量稳态中起作用，并且似乎与原发性高血压和妊娠高血压有关。如果这些作用是主要的，那么地高辛样免疫反应性物质的检测本身可能证明具有价值。
