Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil.
Nutr Clin Pract. 2019 Aug;34(4):558-564. doi: 10.1002/ncp.10234. Epub 2019 Jan 15.
Thiamin is a hydrosoluble vitamin that plays a role in several biological processes, mainly in glucose metabolism. There are several risk factors for developing thiamin deficiency, such as malnutrition, refeeding syndrome, gastrointestinal surgery, and alcoholism. Recently, the role of thiamin in critically ill patients has gained prominence, and the prevalence of thiamin deficiency was found to be increased in patients with severe burns, major surgery, septic shock, end-stage renal disease, and heart failure. In adults, thiamin deficiency presents as encephalopathy, dry beriberi (with neurological signs and symptoms), or wet beriberi (with cardiovascular signs and symptoms). Thiamin deficiency can be diagnosed clinically, and all clinicians should be aware of this disease, especially in patients with risk factors for thiamin deficiency. Thiamin supplementation should be started as early as possible in patients suspected to have thiamin deficiency. Treatment is safe, inexpensive, simple, and life-saving. Diagnosis is confirmed on a positive response to treatment.
硫胺素是一种水溶性维生素，在几种生物过程中发挥作用，主要在葡萄糖代谢中发挥作用。有几个导致硫胺素缺乏的风险因素，如营养不良、重新喂养综合征、胃肠道手术和酗酒。最近，硫胺素在危重症患者中的作用引起了关注，发现严重烧伤、大手术、脓毒性休克、终末期肾病和心力衰竭患者中硫胺素缺乏的患病率增加。在成人中，硫胺素缺乏表现为脑病、干性脚气病（有神经症状和体征）或湿性脚气病（有心血管症状和体征）。硫胺素缺乏可以通过临床诊断，所有临床医生都应该了解这种疾病，尤其是在有硫胺素缺乏风险因素的患者中。对于疑似硫胺素缺乏的患者，应尽早开始补充硫胺素。治疗安全、廉价、简单且可挽救生命。诊断依据是对治疗的积极反应。
