Wenger T L, Butler V P, Haber E, Smith T W
J Am Coll Cardiol. 1985 May;5(5 Suppl A):118A-123A. doi: 10.1016/s0735-1097(85)80471-x.
Sixty-three patients with life-threatening digitalis intoxication were treated with purified fragments of digoxin-specific antibodies (Fab) obtained from sheep. Twenty-eight patients developed toxicity as the result of digitalis ingestion in a suicide attempt, 5 ingested a large amount of digoxin accidentally and 30 developed toxicity in the course of treatment for underlying heart disease. The dosage of digoxin-specific Fab was calculated to be equimolar to the amount of cardiac glycoside in the patient's body. Digitalis toxicity was completely reversed in most cases, with onset of effect usually within 30 minutes of administration of Fab fragments. Unbound and, therefore, active digoxin serum concentrations decreased to undetectable levels within minutes after administration of the fragments. In all patients who had elevated serum potassium concentrations caused by massive digitalis toxicity, treatment with the Fab fragments reversed the hyperkalemia. There were no obvious adverse reactions to treatment. Potentially life-threatening digitalis intoxication can be rapidly and safely reversed by treatment with purified digoxin-specific Fab fragments.
63例有生命危险的洋地黄中毒患者接受了从绵羊身上获取的地高辛特异性抗体（Fab）纯化片段治疗。28例患者因企图自杀服用洋地黄而出现中毒，5例意外摄入大量地高辛，30例在治疗基础心脏病过程中出现中毒。地高辛特异性Fab的剂量计算为与患者体内强心苷的量等摩尔。大多数病例中洋地黄中毒完全逆转，通常在给予Fab片段后30分钟内起效。给药后几分钟内，未结合的、因而具有活性的地高辛血清浓度降至无法检测的水平。在所有因大量洋地黄中毒导致血清钾浓度升高的患者中，用Fab片段治疗可逆转高钾血症。治疗无明显不良反应。用纯化的地高辛特异性Fab片段治疗可迅速、安全地逆转有潜在生命危险的洋地黄中毒。
