青霉胺对肾脏的影响。

Davison A M, Day A T, Golding J R, Thomson D

Department of Renal Medicine, St James's University Hospital, Leeds.

Proc R Soc Med. 1977;70 Suppl 3(Suppl 3):109-13. doi: 10.1177/00359157770700S334.

Twenty patients with rheumatoid arthritis developing proteinuria when being treated with penicillamine have been studied. In 5 the proteinuria was mild and resolved rapidly. Eleven of the remaining patients have undergone renal biopsy. One was found to have amyloidosis, and in the other 10 there was evidence of an immune complex type of injury, manifested by a granular immunoglobulin deposition within glomerular capillary walls associated with subepithelial deposits, found on electron microscopy. The proteinuria associated with this was mild (mean 2.6 g per 24 h) and occurred on average some eight months after commencing therapy (range 6 weeks to 60 months).

对20例在接受青霉胺治疗时出现蛋白尿的类风湿性关节炎患者进行了研究。其中5例蛋白尿症状轻微且很快消失。其余11例患者接受了肾活检。1例被发现患有淀粉样变性，另外10例有免疫复合物型损伤的证据，表现为肾小球毛细血管壁内颗粒状免疫球蛋白沉积，伴有电子显微镜下发现的上皮下沉积物。与此相关的蛋白尿症状较轻（平均每24小时2.6克），平均在开始治疗约8个月后出现（范围为6周至60个月）。