Thomson Allan D, Marshall E Jane
Molecular Psychiatry Laboratory, Windeyer Institute of Medical Sciences, Department of Mental Health Sciences, Royal Free and University College, London Medical School, London UK.
Alcohol Alcohol. 2006 Mar-Apr;41(2):159-67. doi: 10.1093/alcalc/agh250. Epub 2005 Dec 29.
To review the process of identifying alcohol-dependent patients at risk of developing Wernicke's encephalopathy (WE) in the community, and prophylactic treatment options.
Non-systematic literature review of the diagnosis of thiamine deficiency and of its treatment in the community. The role of supplementation of beer and bread with thiamine was evaluated.
The diagnosis of thiamine deficiency is not always made, and treatment apparently may sometimes be inadequate.
Alcohol-dependent patients in the community who are at risk of developing WE should be given thiamine 250 mg, intramuscularly, daily for 3-5 days as part of a community detoxification programme. Further work is essential to determine the optimum dose of thiamine required to prevent permanent brain damage (Korsakoff's Psychosis). Neurotoxicity, due to the metabolism of excessive alcohol in patients with chronic and severe alcohol dependence, must be considered as an important factor in determining the long-term outcome of treatment.
回顾在社区中识别有发生韦尼克脑病（WE）风险的酒精依赖患者的过程以及预防性治疗方案。
对社区中硫胺素缺乏症的诊断及其治疗进行非系统性文献综述。评估了在啤酒和面包中添加硫胺素的作用。
硫胺素缺乏症并非总能得到诊断，而且治疗有时显然可能不充分。
作为社区解毒计划的一部分，社区中存在发生WE风险的酒精依赖患者应每日肌肉注射250毫克硫胺素，持续3 - 5天。进一步的研究对于确定预防永久性脑损伤（柯萨科夫精神病）所需的硫胺素最佳剂量至关重要。在慢性和重度酒精依赖患者中，由于过量酒精代谢导致的神经毒性必须被视为决定治疗长期结果的一个重要因素。
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