Whitley R J, Soong S J, Dolin R, Galasso G J, Ch'ien L T, Alford C A
N Engl J Med. 1977 Aug 11;297(6):289-94. doi: 10.1056/NEJM197708112970601.
We evaluated adenine arabinoside (vidarabine) for treatment of herpes simplex encephalitis in a placebo-controlled study. In 28 cases proved by isolation of Type 1 virus from brain biopsy, treatment reduced mortality from 70 to 28 per cent (P = 0.03), and over 50 per cent of treated survivors had no or only moderately debilitating neurologic sequelae. This improvement was achieved without evidence of acute drug toxicity. Thus, adenine arabinoside has a good therapeutic index (efficacy/toxicity) for the treatment of Type 1 herpes simplex encephalitis. However, the drug must be given early in the course of infection before the advent of coma to have a beneficial effect. Moreover, it should be coupled with brain biopsy for specific diagnosis to avoid unnecessary treatment of nonresponsive encephalitides that can mimic herpes simplex.
我们在一项安慰剂对照研究中评估了阿糖腺苷（阿糖腺嘌呤）治疗单纯疱疹性脑炎的效果。在28例经脑活检分离出1型病毒确诊的病例中，治疗使死亡率从70%降至28%（P = 0.03），超过50%接受治疗的幸存者没有或仅有中度致残性神经后遗症。这种改善在没有急性药物毒性证据的情况下得以实现。因此，阿糖腺苷治疗1型单纯疱疹性脑炎具有良好的治疗指数（疗效/毒性）。然而，该药物必须在感染过程中昏迷出现之前尽早给予才能产生有益效果。此外，应结合脑活检进行特异性诊断，以避免对可模拟单纯疱疹的无反应性脑炎进行不必要的治疗。
