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[慢性酒精中毒患者的硫胺素缺乏症。术前和术后治疗的价值]

[Thiamine deficiency in chronic alcoholics. Value of pre- and postoperative treatment].

作者信息

Dessemond-Negroni M, Pauli A M, Charbit J J, Gauthier C, François G

出版信息

Ann Anesthesiol Fr. 1977;18(10):853-6.

PMID:23027
Abstract

Thiamine deficiency in the chronic alcoholic would appear to have a triple origin: inadequate intake, absorption and utilisation. Its consequences are well known: peripheral neuropathy, WERNICKE and KORSAKOFF type encephalopathies and cardiac problems (with asystole at the extreme). The active principle of thiamine, TPP or cocarboxylase, is involved as a coenzyme of pyruvate decarboxylase and of alphaketoglutarate decarboxylase in the ocidative decarboxylation reactions of the Krebs cycle. TPP is involved as a coenzyme of transketolase in the transketolisation reactions of the pentose pathway. The stimation of transketolase demonstrates a deficiency in thiamine. Fourteen patients suffering from surgical ENT malignancies were involved in the present study. Seven patients received vitamin B therapy before and after the operation. The results showed a significant decrease in thiamine deficiency. Seven were used as controls and did not receive vitamin B therapy. Transketolase estimations showed and increase in the deficiency. Thiamine deficiency exists in the chronic alcoholic and may be corrected by the administration of B vitamins.

摘要

慢性酒精中毒患者的硫胺素缺乏似乎有三个原因

摄入不足、吸收不良和利用障碍。其后果众所周知:周围神经病变、韦尼克脑病和科萨科夫型脑病以及心脏问题(最严重时可出现心搏停止)。硫胺素的活性成分,即硫胺素焦磷酸(TPP)或羧化辅酶,在三羧酸循环的氧化脱羧反应中作为丙酮酸脱羧酶和α-酮戊二酸脱羧酶的辅酶发挥作用。TPP在戊糖途径的转酮醇酶反应中作为转酮醇酶的辅酶发挥作用。转酮醇酶活性的测定可表明硫胺素缺乏。本研究纳入了14例耳鼻喉科手术恶性肿瘤患者。7例患者在手术前后接受了维生素B治疗。结果显示硫胺素缺乏显著减少。7例用作对照,未接受维生素B治疗。转酮醇酶活性测定显示缺乏情况有所增加。慢性酒精中毒患者存在硫胺素缺乏,补充B族维生素可予以纠正。

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