Duquesnoy B, Cocheteux P, Siame J L, Delcambre B
Sem Hop. 1983 May 26;59(21):1641-4.
A series of thirty patients with rheumatoid arthritis in whom D-penicillamine therapy was initiated more than five years ago was analyzed. Results were satisfactory in nine patients: two (6.6%) are still taking D-penicillamine and seven (23%) have experienced stabilization of their disease. In nine patients (28%) therapy was discontinued before the end of the third year because of adverse side-effects; no harmful side-effects were recorded after the third year. In ten patients (33%) D-penicillamine was discontinued because of ineffectiveness, either during the first year because of non-responsiveness (3 patients) or after the first two years because of escape phenomenon (7 patients). The authors compare their series to those previously reported in the medical literature. They believe that D-penicillamine should be given in progressive and moderate doses (averaging 600 mg per day). The mean duration of therapy with D-penicillamine was 27 months, lower than that recorded with chrysotherapy or anti-malarials; in 30% of patients, D-penicillamine was discontinued because of adverse side-effects. These findings show that, though D-penicillamine may be useful, it should be considered only after chrysotherapy.
对一系列30例类风湿性关节炎患者进行了分析，这些患者在五年多以前就开始接受青霉胺治疗。9例患者的治疗结果令人满意：2例（6.6%）仍在服用青霉胺，7例（23%）病情已稳定。9例患者（28%）在第三年末之前因出现副作用而停药；第三年后未记录到有害副作用。10例患者（33%）因无效而停用青霉胺，其中3例在第一年因无反应而停药，7例在头两年后因逃逸现象而停药。作者将他们的病例系列与医学文献中先前报道的病例进行了比较。他们认为，青霉胺应以递增的适中剂量给药（平均每天600毫克）。青霉胺治疗的平均持续时间为27个月，低于金疗法或抗疟药的记录；30%的患者因副作用而停用青霉胺。这些发现表明，尽管青霉胺可能有用，但应仅在金疗法之后才考虑使用。
