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青霉胺是一种含巯基的氨基酸,原用于治疗肝豆状核变性、金中毒、铅中毒等,近年来用于治疗慢性类风湿性关节炎。考虑到多数类风湿患者血中有类风湿因子(简称RF,是一种巨球蛋白),而D-青霉胺可能使巨球蛋白的二硫链断裂而发生解聚,降低RF水平,故应用此药。临床应用:1970年Kruger用D-青霉胺治疗14例类风湿性关节炎患者,除1例用药9个月外,其余均用药一年以上,开始剂量每日静注1克,5～7日后改为每日口服1,800毫克,少数病人为900毫克/日,个别只用300毫克/ 日。所有病例在疗程开始10个月内均得到缓解,并且停止一切药物治疗,观察二年,病情稳定。临床效果最明显的是血沉恢复,继而血象及血浆蛋白恢复正常,指围略有减小,握力明显增加。Miehlke用长疗程治疗93例,剂量0.3～1.5克/日,结果好转70例,改善11例,无效12例。其中血沉低者55例,RF滴度下降者44例。 1973年有人采用双盲试验,口服青霉胺对
Penicillamine is a sulfhydryl-containing amino acid, originally used for the treatment of Wilson’s disease, gold poisoning, lead poisoning, etc., in recent years for the treatment of chronic rheumatoid arthritis. Taking into account the majority of rheumatoid patients with rheumatoid factor in the blood (RF, is a macroglobulin), and D-penicillamine may disrupt the macroglobulin disulfide chain and depolymerization, reducing the RF level, so Apply this medicine. Clinical application: In 1970 Kruger D-penicillamine treatment of 14 patients with rheumatoid arthritis, except for 1 case of medication for 9 months, the rest were medication more than one year, the initial dose of intravenous 1 gram, 5 to 7 In the future changed to oral 1,800 mg daily, a small number of patients for 900 mg / day, only 300 mg / day. All cases were relieved within 10 months of starting treatment, and all drug treatment was stopped. After two years of observation, the condition was stable. The most obvious clinical effect is erythrocyte sedimentation rate, then blood and plasma protein returned to normal, refers to a slight reduction in grip strength increased significantly. Miehlke treatment with a long course of 93 cases, a dose of 0.3 to 1.5 grams / day, the results improved in 70 cases, 11 cases improved, 12 cases ineffective. Among them, 55 cases had low ESR and 44 cases had decreased RF titer. 1973 was double-blind test, oral penicillamine pair