Patel Priti N
Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health Professions, St. John's University, St. Albert Hall, Rm. 114, 8000 Utopia Pkwy., Queens, NY 11439-0001, USA.
Ann Pharmacother. 2006 Feb;40(2):299-303. doi: 10.1345/aph.1G114. Epub 2006 Jan 3.
To evaluate the use of methylene blue for the treatment of ifosfamide-induced encephalopathy.
MEDLINE (1966-August 2005) and International Pharmaceutical Abstracts (1971-August 2005) were searched using the terms methylene blue, ifosfamide, encephalopathy, and neurotoxicity.
Several case reports and one retrospective chart review described the use of methylene blue for ifosfamide-induced encephalopathy, but no controlled clinical trials were found. Methylene blue appeared to aid in the resolution of encephalopathic symptoms as rapidly as within 10 minutes of administration in some patients, but it had modest efficacy in most patients. Symptoms in patients who did not receive methylene blue resolved in the same time frame; this indicates that ifosfamide-induced encephalopathy may resolve without treatment.
Available data from case reports indicate that methylene blue is an option in the treatment of ifosfamide-induced encephalopathy, especially in patients with severe symptoms of toxicity. However, the lack of controlled clinical trials and the possibility of spontaneous resolution of encephalopathy make the usefulness of methylene blue unclear.
评估亚甲蓝用于治疗异环磷酰胺所致脑病的效果。
使用检索词“亚甲蓝”“异环磷酰胺”“脑病”和“神经毒性”检索了MEDLINE（1966年至2005年8月）及国际药学文摘数据库（1971年至2005年8月）。
数篇病例报告及一项回顾性图表分析描述了亚甲蓝用于治疗异环磷酰胺所致脑病的情况，但未发现对照临床试验。在一些患者中，亚甲蓝似乎能在给药后10分钟内迅速帮助缓解脑病症状，但对大多数患者疗效一般。未接受亚甲蓝治疗的患者症状在相同时间内缓解；这表明异环磷酰胺所致脑病可能无需治疗即可缓解。
病例报告中的现有数据表明，亚甲蓝是治疗异环磷酰胺所致脑病的一种选择，尤其是对有严重毒性症状的患者。然而，缺乏对照临床试验以及脑病可能自发缓解，使得亚甲蓝的有效性尚不清楚。
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