Koren G, Farine D, Grundmann H, Heyes J, Soldin S, Taylor J, MacLeod S M
Division of Clinical Pharmacology, Hospital for Sick Children, Ont., Canada.
Dev Pharmacol Ther. 1988;11(2):82-7. doi: 10.1159/000457670.
We assessed the existence of endogenous digoxin-like substance(s) (EDLS) in mother-neonate pairs using a routine radioimmunoassay for digoxin. None of those studied had been treated with cardiac glycosides during or before pregnancy. In uneventful pregnancies, cord EDLS levels (0.31 +/- 0.02 ng/ml mean +/- SEM) were significantly higher (p less than 0.001) than both antepartum and postpartum maternal levels (0.14 +/- 0.02 and 0.17 +/- 0.02 mg/ml, respectively). This observation was in contrast with findings in high-risk pregnancies. In general, EDLS levels in the high-risk group were significantly higher than in normal pregnancies (cord 0.94 +/- 0.38 ng/ml; antepartum 1.63 +/- 0.54 ng/ml; postpartum 0.89 +/- 0.73 ng/ml). In the high-risk group there was a remarkably wide range of maternal and cord EDLS concentrations. The present studies suggest that following pregnancies of high risk for a variety of reasons, EDLS determination may be commonly high in the perinatal period and may affect the determination of 'true' digoxin. Consequently, digoxin dosing based on monitoring drug concentration may be futile.
我们使用常规地高辛放射免疫分析法评估母婴对中内源性洋地黄样物质（EDLS）的存在情况。所有研究对象在孕期或孕前均未接受过强心苷治疗。在正常妊娠中，脐血EDLS水平（平均±标准误为0.31±0.02 ng/ml）显著高于产前和产后母体水平（分别为0.14±0.02和0.17±0.02 ng/ml，p<0.001）。这一观察结果与高危妊娠的发现形成对比。一般来说，高危组的EDLS水平显著高于正常妊娠组（脐血0.94±0.38 ng/ml；产前1.63±0.54 ng/ml；产后0.89±0.73 ng/ml）。在高危组中，母体和脐血EDLS浓度范围非常广泛。目前的研究表明，在因各种原因导致的高危妊娠后，围产期EDLS测定值可能普遍较高，可能会影响“真正”地高辛的测定。因此，基于监测药物浓度的地高辛给药可能是徒劳的。
