摘要
目的观察依地酸钙钠(EDTA)与小剂量二巯丙磺酸钠(DMPS)在脑型Wilson病中的临床驱铜疗效对比。方法回顾性收集80例2019年2月-2021年9月安徽中医药大学第一附属医院脑病中心Wilson病脑型患者的临床资料,并根据治疗方法分为EDTA组(n=39例)和小剂量DMPS组(n=41例)。根据基线资料对两组患者进行倾向性评分匹配(PSM),比较匹配后两组的驱铜疗效,并观察有无驱铜恶化现象及不良反应。结果PSM后最终纳入EDTA组和小剂量DMPS组患者各35例。EDTA组UWDRSⅠ治疗前后有统计学差异[(57.03±21.06)比(54.40±20.02),t=7.256,P<0.001],小剂量DMPS组UWDRSⅠ治疗前后无统计学差异[(53.49±26.82)比(52.37±27.17),t=1.544,P=0.129]。EDTA组与小剂量DMPS组相比,24 h尿铜无明显差异[551.18(417.77,843.47)比489.20(389.64,839.47),Z=-0.029,P>0.05],驱铜恶化现象有统计学差异(0比17.14%,P=0.025),不良反应明显减少。结论EDTA与小剂量DMPS在脑型WD患者中驱铜均有效,但EDTA组症状改善优于小剂量DMPS组,驱铜恶化几率少,不良反应少,可作为脑型WD患者的一种驱铜治疗方式。
Objective To compare the clinical efficacy of calcium sodium edetate(EDTA)and the low-dose sodium dimercaptopropanesulfonate(DMPS)in treating cerebral Wilson’s disease.Methods Eighty patients with neurological Wilson’s disease in the neurology department of the first affiliated hospital of Anhui traditional Chinese medicine from February 2019 to September 2021 were collected and divided into the EDTA treatment group(n=39)and the low-dose DMPS control group(n=41)based on treatments.Propensity score matching(PSM)was performed on the two groups of patients and the results were compared after matching.The copper displacement effects of the two groups were compared,and the deterioration of copper displacement and adverse reactions were observed.Results After PSM,35 patients in EDTA group and 35 patients in the low-dose DMPS group were included.UWDRSⅠin EDTA group showed significant statistical difference after treatment[(57.03±21.06)versus(54.40±20.02),t=7.256,P<0.001],while UWDRSⅠin the low-dose DMPS group showed no significant statistical difference[(53.49±26.82)versus(52.37±27.17),t=1.544,P=0.129].Compared with the low-dose DMPS group,there was no significant difference in 24-hour urinary copper detection in the EDTA group[551.18(417.77,843.47)versus 489.20(389.64,839.47),Z=-0.029,P>0.05].The neurological deterioration(P=0.025)and adverse reactions were significantly reduced.Conclusion EDTA and low-dose DMPS have the same effect in expelling copper in patients with neurological WD,with better improvement,less neurological deterioration probability,and fewer adverse reactions.EDTA can be used as a copper removing treatment for patients with neurological WD.
作者
李俊
陈怀珍
胡亚飞
朱四欢
韩超
许二赫
杨文明
LI Jun;CHEN Huaizhen;HU Yafei(Department of Neurology,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,China)
出处
《中风与神经疾病杂志》
CAS
2022年第3期238-241,共4页
Journal of Apoplexy and Nervous Diseases
基金
国家自然科学基金(81973825)
高校优秀拔尖人才培育资助项目(gxgwfx2021029)
安徽省高校科学研究项目(KJ2021A058)
国家中医药管理局《中医药循证能力建设项目》(2019XZZX-NB001)
安徽省高校协同创新项目(GXXT-2020-025)
安徽中医药大学新安医学教育部重点实验室开放基金(2020xayx12)。
关键词
WILSON病
依地酸钙钠
二巯丙磺酸钠
驱铜恶化
不良反应
Wilson’s disease
Sodium 2,3-dimercapto-1-propane sulfonate
Calcium sodium edetate
Neurological Deterioration
Adverse reactions
