Burse R L, Landowne M, Young A J, Maher J T
Aviat Space Environ Med. 1982 Mar;53(3):221-5.
Phenytoin sodium was evaluated for its effect on the development and intensity of acute mountain sickness (AMS) because of its ability to reduce intracellular Na+ concentrations in brain and thereby minimize any tendency to increase cellular volume, a hypothetical cause of AMS. Six men aged 19-35 were exposed to approximately 4600 m altitude in a hypobaric chamber for 52 h on two occasions separated by 10 d at sea level. Subjects received wither phenytoin or placebo for 18 h before (700 mg, divided dose) and throughout (100 mg t.i.d.) each altitude exposure in a double-blind, repeated-measures (crossover) design. Phenytoin serum concentrations ranged from 4.4-13.9 micrograms/ml during altitude exposure. Twice daily questionnaires and clinical evaluations showed no marked benefit from phenytoin on the occurrence, severity, or duration of AMS symptoms: headache, nausea, insomnia, and general malaise. Overall, 1 subject felt better, 2 felt worse, 1 felt the same; 2 were not suitably comparable. There was no observed relationship between serum levels and symptoms of AMS. Moderate degrees of weakness and dizziness were each reported by 3 subjects with phenytoin but not with placebo, however. Resting pulmonary ventilation, end-tidal PO2 and PCO2, map reading abilities and respiratory mask donning times were not affected by phenytoin. Under the conditions of this trial, phenytoin did not appear to be useful in managing AMS.
由于苯妥英钠能够降低大脑细胞内的钠离子浓度，从而最大限度地减少细胞体积增加的趋势（这是急性高山病的一种假设病因），因此对其在急性高山病（AMS）的发生和严重程度方面的作用进行了评估。6名年龄在19至35岁之间的男性在低压舱中暴露于约4600米的海拔高度52小时，分两次进行，两次间隔10天在海平面。在每次海拔暴露前18小时（700毫克，分剂量）及整个过程中（100毫克，每日三次），受试者接受苯妥英或安慰剂，采用双盲、重复测量（交叉）设计。在海拔暴露期间，苯妥英的血清浓度范围为4.4至13.9微克/毫升。每日两次的问卷调查和临床评估显示，苯妥英对AMS症状（头痛、恶心、失眠和全身不适）的发生、严重程度或持续时间没有明显益处：总体而言，1名受试者感觉较好，2名感觉较差，1名感觉相同；2名不具有可比性。未观察到血清水平与AMS症状之间的关系。然而，有3名服用苯妥英的受试者报告有中度程度的虚弱和头晕，而服用安慰剂的受试者则没有。静息肺通气、呼气末氧分压和二氧化碳分压、地图阅读能力以及佩戴呼吸面罩的时间均不受苯妥英影响。在本试验条件下，苯妥英似乎对治疗AMS无用。
