青霉胺、锌剂治疗肝豆状核变性的疗效及对尿铜排泄作用的比较

A COMPARISON OF EFFICACY AND URINARY COPPER EXCRETION IN THE TREATMENT OF HEPATOLENTICULAR DEGENERATION WITH PENICILLAMINE AND ZINC

比较青霉胺及锌剂治疗肝豆状核变性（ＨＬＤ）的疗效及对尿铜排泄的作用。用阳极溶出伏安法（ＡＳＶ法）测定患者的 ２４ ｈ尿铜排泄量，资料分析采用 Ｘ２检验及 ｔ检验。结果： ６９例用青霉胺及锌剂治疗的 ＨＬＤ患者，青霉胺治疗组疗程为 １０．２５± ３．８４ ａ，有效率为 ９４．２％。锌剂治疗组疗程为 ３．６２± ０．９４ ａ，有效率为 ５８．８％。治疗同期的尿铜排泄量青霉胺组明显高于锌剂组（Ｐ＜０．０１）。结论：青霉胺疗效明显优于锌剂，青霉胺较锌剂更能有效地驱除造成组织损害的体内已蓄积的过量游离铜。

PURPOSE To compare the efficacy and urinary copper excretion in the treatment of hepatolenticular degeneration (HLD) with penicillamine and zinc. METHODS The outputs of urinary copper were measured by anodic stripping voltammetry method. Data were analyzed with X2 test and t test. RESULTS Sixty-nine patients with HLD treated with penicillamine and zinc has been reported. Mean courses of treatment with penicillamine were 10.25± 3.84 years and the effective rate was 94.2 %. Mean courses of treatment with zinc were 3.62± 0.94 years and the effective rate was 58.8 %. At the same time the outputs of urinary copper of the group treated with penicillamine were higher obviously than the group treated with zinc (P< 0.01 ). CONCLUSIONS The efficacy of treatment with penicillamine was superior to zinc therapy. Penicillamine may be more effective in getting rid of excessive free copper of tissues than zinc.