大剂量胃肠外给予硫胺素治疗韦尼克脑病：病例系列及文献综述
High-dose Parenteral Thiamine in Treatment of Wernicke's Encephalopathy: Case Series and Review of the Literature.
作者信息
Nishimoto Andrew, Usery Justin, Winton John C, Twilla Jennifer
机构信息
Department of Pharmacy, Methodist University Hospital, Memphis, TN, U.S.A.
Department of Clinical Pharmacy, University of Tennessee, Memphis, TN, U.S.A.
出版信息
In Vivo. 2017 Jan 2;31(1):121-124. doi: 10.21873/invivo.11034.
BACKGROUND
Thiamine deficiency can lead to Wernicke's encephalopathy (WE), an acute and potentially life-threatening neurological disorder. Even though the main treatment modality for WE consists of thiamine replacement, evidence supporting an optimal dosing strategy and duration is unclear.
PATIENTS AND METHODS
We present a single-center case series of eleven patients that were admitted with possible WE and treated with high-dose parenteral thiamine.
RESULTS
Patients with suspected WE were treated with ≥500 mg intravenous thiamine for a median of 3 days with 73% of patients (eight out of eleven) displaying symptom resolution or improvement after treatment. No significant correlation between symptom resolution and timing of high-dose thiamine initiation (median=92 h) was identified. In patients whose symptoms resolved compared to those whose symptoms did not, there were no differences in patient variables nor adverse effects related to thiamine treatment.
CONCLUSION
High-dose thiamine (≥500 mg) appears safe and efficacious for use in patients with suspected WE.
背景
硫胺素缺乏可导致韦尼克脑病（WE），这是一种急性且可能危及生命的神经系统疾病。尽管WE的主要治疗方式是补充硫胺素，但支持最佳给药策略和疗程的证据尚不清楚。
患者与方法
我们呈现了一个单中心病例系列，包括11例因可能患有WE入院并接受大剂量胃肠外硫胺素治疗的患者。
结果
疑似WE的患者接受了≥500毫克静脉注射硫胺素治疗，中位疗程为3天，73%的患者（11例中的8例）在治疗后症状缓解或改善。未发现症状缓解与大剂量硫胺素开始使用时间（中位值 = 92小时）之间存在显著相关性。与症状未缓解的患者相比，症状缓解的患者在患者变量或硫胺素治疗相关不良反应方面没有差异。
结论
大剂量硫胺素（≥500毫克）用于疑似WE的患者似乎安全有效。
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