Bouchard Nicole C, Howland Mary Ann, Greller Howard A, Hoffman Robert S, Nelson Lewis S
NYC Poison Control Center, New York, NY, USA.
Mayo Clin Proc. 2005 Apr;80(4):541-5. doi: 10.4065/80.4.541.
In response to concerns regarding the safety of ephedra-containing dietary supplements, manufacturers have marketed "ephedra-free" products. Many of these contain synephrine, a sympathomimetic amine from the plant Citrus aurantium. Synephrine is structurally similar to ephedrine and has vasoconstrictor properties. We describe a 38-year-old patient with ischemic stroke associated with an ephedra-free dietary supplement containing synephrine and caffeine. The patient presented with memory loss and unsteady gait after taking 1 or 2 capsules per day of a dietary supplement (Stacker 2 Ephedra-Free) for 1 week. He had no notable medical history or major atherosclerotic risk factors and took no other medications. Physical examination showed a mildly ataxic gait and substantial Impairment of both concentration and memory. Computed tomography and magnetic resonance Imaging of the brain showed subacute infarctions in the left thalamus and left cerebellum in the distribution of the vertebrobasilar circulation. Other causes of ischemic stroke were evaluated, and findings were unremarkable; a vasospastic origin was considered most likely. The patient was discharged with nearly complete resolution of symptoms. Synephrine, a sympathomimetic amine related to ephedrine, may be associated with Ischemic stroke. Consumers and clinicians need to be Informed about the potential risks of ephedra-free products.
针对含麻黄碱的膳食补充剂的安全性问题，制造商推出了“无麻黄碱”产品。其中许多产品含有辛弗林，一种来自酸橙属植物的拟交感神经胺。辛弗林在结构上与麻黄碱相似，具有血管收缩特性。我们描述了一名38岁的患者，其缺血性中风与一种含辛弗林和咖啡因的无麻黄碱膳食补充剂有关。该患者在每天服用1或2粒膳食补充剂（Stacker 2无麻黄碱）1周后出现记忆力减退和步态不稳。他没有明显的病史或主要的动脉粥样硬化危险因素，也未服用其他药物。体格检查显示轻度共济失调步态，注意力和记忆力均有明显损害。脑部计算机断层扫描和磁共振成像显示，在椎基底动脉循环分布区域，左侧丘脑和左侧小脑有亚急性梗死。对缺血性中风的其他病因进行了评估，结果无明显异常；最可能的病因被认为是血管痉挛。患者出院时症状几乎完全缓解。与麻黄碱相关的拟交感神经胺辛弗林可能与缺血性中风有关。消费者和临床医生需要了解无麻黄碱产品的潜在风险。
