摘要
目的 直接测定和间接估算心功能不全患者的血清内源性地高辛样免疫活性物质 (digoxin likeimmunoreactivesub stances,DLIS)的浓度。方法 用荧光偏振免疫分析法 (FPIA ,TDx仪 )测定 15例未接受地高辛治疗的心衰患者血清表观地高辛 (DLIS)浓度。对 12例已用地高辛的心衰患者 ,在测定地高辛总浓度 (FPIA)和游离浓度 (超滤 /FPIA)后 ,计算其血清DLIS浓度。结果 以TDx仪最低检测限 0 .2 6nmol·L-1为检出标准 ,心衰患者血清DLIS检出阳性率为 4 6 .7% (7/15 ) ,其浓度范围 (0 .2 6～ 1.5 2 )nmol·L-1,平均浓度 (0 .5 5± 0 .4 4 )nmol·L-1;其中 1例患者血清DLIS浓度高达 1.5 2nmol·L-1。已用地高辛的心衰患者血清实测地高辛游离浓度为 (0 .79± 0 .4 8) (0 .4 1～ 2 .10 )nmol·L-1;实测地高辛总浓度为 (1.31± 0 .80 )nmol·L-1,明显高于计算的地高辛总浓度 (1.0 5± 0 .6 4 )nmol·L-1(P <0 .0 1)。计算的DLIS浓度为 (0 .2 6± 0 .19) (0 .0 7～ 0 .76 )nmol·L-1。结论 心功能不全患者血清中含有一定量的DLIS ;提示这些患者使用地高辛治疗时 ,免疫分析法测得的血清地高辛浓度结果易引起“过高估计”。
OBJECTIVE: To determine directly and calculate indirectly the concentrations of digoxin-like immunoreactive substances (DLIS) in serum in the patients with cardiac insufficiency. METHODS: The apparent digoxin concentrations in serum were determined in 15 inpatients with cardiac insufficiency without receiving digoxin by fluorescence polarization immunoassay (FPIA) with TDx analyser. The concentrations of serum DLIS in twelve patients with cardiac failure were calculated after determinations of total digoxin by FPIA and free digoxin by ultrafiltration with FPIA. The lowest measureble level for FPIA with TDx analyser was 0.26 nmol· L -1. RESULTS: In the patients with cardiac insufficiency not receiving digoxin, the positive ratio for determination of DLIS was 46.7% (7 in 15 cases), and its mean serum concentration was (0.55 ± 0.44) nmol·L-1(range 0.26 ∼ 1.52 nmol·L-1). In the patients with cardiac failure receiving digoxin therapy, the free digoxin concentration in serum determined was (0.79 ± 0.48) (0.41 ∼ 2. 10) nmol·L-1. The total digoxin concentration determined (1. 31 ± 0.80 nmol·L-1) was significantly higher than the calculated total digoxin (1.05 ± 0.64 nmol·L -1)(P-1. The results suggested the presence of elevated DLIS in serum for these patients above and were well consistent with that obtained by recently published method of Dasgupta et al. CONCLUSION: There are certain increased concentrations of DLIS in sera of the patients with cardiac insufficiency, suggesting that digoxin levels measured by immunoassay method must be interpreted carefully in these patients after treatment with digoxin or other digitalis preparations.
出处
《中国药学杂志》
EI
CAS
CSCD
北大核心
2003年第10期782-784,共3页
Chinese Pharmaceutical Journal
基金
国家自然科学基金 (No .3 9670 843 )
人事部留学回国人员科研基金资助课题 (1997 2 0 1)
