Gibson T P, Nelson H A
Clin Pharmacol Ther. 1980 Feb;27(2):219-23. doi: 10.1038/clpt.1980.34.
Using high-performance liquid chromatography (HPLC) to separate digoxin from its metabolites digoxigenin, digoxigenin-bis-digitoxoside, and digoxigenin-mono-digitoxoside with subsequent quantitation by 125I radioimmunoassay (RIA), we examined the plasma of patients on long-term oral digoxin therapy. Digoxin was also measured by RIA without prior HPLC separation. Nine patients requiring maintenance dialysis and 9 subjects with lesser degrees of renal impairment were studied. Trace amounts of 1 or more of the digoxin metabolites were found in the plasma of all dialysis patients while subjects with lesser degrees of renal failure had either none or only 1 metabolite in trace amounts. The ratio of HPLC digoxin without HPLC was 0.83 +/- 0.12 (SD) in renal failure patients and 1.06 +/- 0.09 in subjects with renal function (p less than 0.01). RIA overestimates the amount of digoxin in plasma of renal failure patients and in them from 6% to 42% of plasma digoxin, as determined by conventional 125I RIA, may represent compounds other than digoxin.
我们采用高效液相色谱法（HPLC）将地高辛与其代谢产物洋地黄毒苷、洋地黄毒苷双洋地黄毒糖甙及洋地黄毒苷单洋地黄毒糖甙分离，随后通过¹²⁵I放射免疫测定法（RIA）进行定量分析，以此检测长期接受口服地高辛治疗患者的血浆。地高辛也在未经HPLC分离的情况下通过RIA进行测量。研究对象包括9例需要维持性透析的患者以及9例肾功能损害程度较轻的受试者。在所有透析患者的血浆中均发现痕量的1种或多种地高辛代谢产物，而肾功能损害程度较轻的受试者则未检测到或仅检测到痕量的1种代谢产物。肾功能衰竭患者中经HPLC测定的地高辛与未经HPLC测定的地高辛之比为0.83±0.12（标准差），肾功能正常的受试者该比值为1.06±0.09（p<0.01）。RIA高估了肾功能衰竭患者血浆中的地高辛含量，按照传统¹²⁵I RIA测定，其中6%至42%的血浆地高辛可能代表除地高辛以外的化合物。
