Honda S A, Rios C N, Murakami L, Morita T, Scottolini A G, Bhagavan N V
Kaiser Foundation Hospital, University of Hawaii Integrated Hawaii Residency Program, Department of Pathology, Honolulu, USA.
J Clin Lab Anal. 1995;9(6):407-12. doi: 10.1002/jcla.1860090612.
Determination of free digoxin levels in patients treated with digoxin immune FAb has long been a problematic area in clinical laboratory testing. The older radioimmunoassays resulted in inaccurate and variable results due to the competition of the administered drug with the radioactively labelled forms. The 1995 Physicians' Desk Reference continues to state that digoxin immune FAb will interfere with digitalis immunoassay measurements. This statement, however, is based primarily on the RIA methods. We evaluated the Stratus digoxin assay and the TDX digoxin II assay. Increasing amounts of immune FAb were added in a stepwise fashion to 12 patient samples containing high normal to elevated digoxin levels. Results showed a progressive decrease in digoxin levels when assayed with the Stratus kit. However, five patient samples tested with the TDX kit resulted in constant digoxin values despite the presence of increasing digibind levels. These results suggest that the Stratus method measures free digoxin, whereas the TDX method measures the total digoxin. Measurement of digoxin by the Stratus method is simple and quick. The Stratus digoxin assay may be an accurate and objective way of measuring free digoxin levels in patients on digoxin immune FAb.
在接受地高辛免疫Fab治疗的患者中，测定游离地高辛水平长期以来一直是临床实验室检测中的一个难题。由于所给予的药物与放射性标记形式之间的竞争，较老的放射免疫测定法导致结果不准确且不稳定。1995年的《医师案头参考》仍指出地高辛免疫Fab会干扰洋地黄免疫测定。然而，这一说法主要基于放射免疫测定法。我们评估了Stratus地高辛测定法和TDX地高辛II测定法。将逐渐增加量的免疫Fab逐步添加到12份地高辛水平处于高正常至升高范围的患者样本中。结果显示，用Stratus试剂盒检测时，地高辛水平逐渐下降。然而，用TDX试剂盒检测的5份患者样本，尽管地高辛抗体水平不断升高，地高辛值却保持不变。这些结果表明，Stratus方法测定的是游离地高辛，而TDX方法测定的是总地高辛。用Stratus方法测定地高辛简单快捷。Stratus地高辛测定法可能是一种准确、客观地测定接受地高辛免疫Fab治疗患者游离地高辛水平的方法。
