4种驱铜新药治疗肝豆状核变性的临床不良反应

OBSERVATION OF THE ADVERSE DRUG REACTIONS OF FOUR COPPER ANTAGONISTS

目的：观察比较葡萄糖酸锌、二巯基丁二酸（ＤＭＳＡ）、二巯基丙磺酸钠（ＤＭＰＳ）、依地酸钙钠（ＥＤＴＡ）等４种常用驱铜药物的不良反应。方法：随机将３７２例（男性２３３例，女性１３９例）肝豆状核变性患者分为４组，分别予葡萄糖酸锌、ＤＭＳＡ、ＤＭＰＳ、ＥＤＴＡ，观察各组患者临床不良反应。结果：葡萄糖酸锌组出现不良反应５例（２５０％），ＤＭＳＡ组３８例（６１３％），ＤＭＰＳ组２７例（５４０％），ＥＤＴＡ组８９例（３７１％）。实验室指标显示ＤＭＳＡ主要显著降低血小板，ＥＤＴＡ和ＤＭＰＳ主要对白细胞抑制较明显，且ＥＤＴＡ能明显促进尿锌、铁、钙的排泄。结论：４种药物中葡萄糖酸锌不良反应最少见，ＥＤＴＡ不良反应最多见；ＥＤＴＡ及葡萄糖酸锌组有效率较低。

OBJECTIVE:Comparison of the ADRs of four copper antagonists,zinc gluconate,mesodimercaptosuccinic acid (DMSA),sodium 2,3dimercapto1propanesulfonate(DMPS),and sodium edetate(EDTA),in treatment of Wilson's disease.METHODS:372 patients with Wilson's disease were randomly divided to receive zinc gluconate,DMSA,DMPS and EDTA and the ADRs of these drugs were observed during treatment.RESULTS:The Occurrence of ADRs observed in the study were:25% for zinc gluconate,61.3% for DMSA,54.0% for DMPS and 37.1% for EDTA.Laboratory data indicated:BPC was significantly reduced by DMSA;WBC was significantly inhibited by EDTA and DMPS; and urinary zinc,ferrium and calcium excretion were increased by EDTA.CONCLUSION:Among the four drugs,zinc gluconate has the least ADRs,and EDTA has the most ADRs.