Avina-Zubieta J A, Johnson E S, Suarez-Almazor M E, Russell A S
Rheumatic Disease Unit, University of Alberta, Edmonton, Canada.
Br J Rheumatol. 1995 Feb;34(2):166-70. doi: 10.1093/rheumatology/34.2.166.
A retrospective review of 4405 patients' charts identified 214 patients who initiated antimalarial therapy between January 1987 and April 1993 for different rheumatic disorders (mean duration of therapy of 17 months). From these, three patients with myopathy were found for a total of 303 patient-years of therapy, for an incidence of 1 in 100 patient-years (95%, confidence interval 0.2-3). All three patients had rheumatoid arthritis and had received chloroquine for between 12 and 18 months with a maximum dose of 250 mg/daily. All had a muscle biopsy, but only one showed the classical rimmed vacuoles. All patients improved within 2 months after the drug was stopped. A review of the literature was carried out with special reference to the significance of clinical myopathy with a negative biopsy. We found that positive biopsies are usual only if the duration of symptoms have been allowed to persist for more than 6 months.
对4405例患者的病历进行回顾性研究，确定了214例在1987年1月至1993年4月期间因不同风湿性疾病开始抗疟治疗的患者（平均治疗时间为17个月）。其中，发现3例患有肌病，治疗总时长为303患者年，发病率为每100患者年1例（95%，置信区间0.2 - 3）。所有3例患者均患有类风湿性关节炎，接受氯喹治疗12至18个月，最大剂量为每日250毫克。所有患者均进行了肌肉活检，但只有1例显示出典型的边缘空泡。所有患者在停药后2个月内病情均有改善。对文献进行了回顾，特别提及了活检阴性的临床肌病的意义。我们发现，只有当症状持续时间超过6个月时，活检通常才呈阳性。
