Smolarz A, Roesch E, Lenz E, Neubert H, Abshagen P
J Toxicol Clin Toxicol. 1985;23(4-6):327-40. doi: 10.3109/15563658508990641.
34 patients aged between 2 and 80 years were treated with digoxin specific antibody (Fab) fragments for severe digitalis poisoning. In 27 cases, the glycoside was taken with suicidal intent; in 3 cases accidentally and 4 were iatrogenic. The following criteria were considered to be indications for use of Fab fragments: the appearance of life-threatening arrhythmias such as high-grade atrioventricular conduction disorders (grade 2 and 3 A-V block), multifocal ectopic beats, ventricular tachycardia, and relapsing ventricular fibrillation. Serum digoxin concentrations were between 3.4 and 29ng/ml before the start of treatment. Between 240 and 800mg of Fab were administered; the majority of patients received 480mg. Regression of arrhythmias was seen between 0.5 and 8 hours after Fab infusion. There was a rapid fall in the free digoxin in the serum to concentrations that were no longer measurable and a marked rise in bound digoxin with a simultaneous increase of excretion of bound digoxin in the urine. Fab therapy is considered to be a major advance in the treatment of severe, previously fatal, glycoside poisoning. No notable side effects or allergic reactions were observed.
34例年龄在2至80岁之间的患者因严重洋地黄中毒接受了地高辛特异性抗体（Fab）片段治疗。其中27例患者是出于自杀意图服用了该糖苷；3例为意外服用，4例是医源性的。以下标准被视为使用Fab片段的指征：出现危及生命的心律失常，如高度房室传导阻滞（2级和3级房室传导阻滞）、多源性异位搏动、室性心动过速以及反复发生的心室颤动。治疗开始前血清地高辛浓度在3.4至29ng/ml之间。给予了240至800mg的Fab；大多数患者接受了480mg。在输注Fab后0.5至8小时内可见心律失常缓解。血清中游离地高辛迅速下降至无法测量的浓度，结合型地高辛显著升高，同时尿中结合型地高辛排泄增加。Fab疗法被认为是治疗严重的、以往可致命的糖苷中毒的一项重大进展。未观察到明显的副作用或过敏反应。
