Brady J A, Rock C L, Horneffer M R
McAuley Health System, Ann Arbor, Mich., USA.
J Am Diet Assoc. 1995 May;95(5):541-4. doi: 10.1016/S0002-8223(95)00148-4.
To assess the prevalence of thiamin deficiency in patients with congestive heart failure who are treated with diuretics that inhibit sodium and chloride reabsorption in the thick ascending limb of the loop of Henle (loop diuretic therapy).
A cross-sectional investigation of thiamin status of consecutive patients with congestive heart failure being treated with loop diuretic therapy.
Cardiology clinic of a midwestern tertiary-care medical center.
Thirty-eight patients were recruited (mean age +/- standard deviation = 55 +/- 14 years). Validation of methodology was conducted with nine age-matched control subjects.
Thiamin status was assessed biochemically by in vitro erythrocyte transketolase activity assay. Assessment of dietary intake of thiamin was accomplished with a semiquantitative food frequency questionnaire.
Fisher's exact test and logistic regression were used to evaluate relationships between thiamin status and variables of interest.
Biochemical evidence of thiamin deficiency was found in 8 of 38 (21%) patients. Evidence of risk for dietary thiamin inadequacy was found in 10 of 38 patients (25%). Seven of the 8 patients with biochemical evidence of thiamin deficiency met study criteria for dietary adequacy, although quantified data suggested that only 4 of the patients achieved two thirds of the Recommended Dietary Allowance. Biochemical evidence of thiamin deficiency tended to be more common among patients with poor left ventricular ejection fractions (P = .07).
Thiamin deficiency may occur in a substantial proportion of patients with congestive heart failure, and dietary inadequacy may contribute to increased risk.
评估接受髓袢利尿剂治疗（抑制髓袢升支粗段钠和氯重吸收的利尿剂治疗）的充血性心力衰竭患者中硫胺素缺乏的患病率。
对接受髓袢利尿剂治疗的连续性充血性心力衰竭患者的硫胺素状态进行横断面调查。
中西部三级医疗中心的心脏病诊所。
招募了38名患者（平均年龄±标准差=55±14岁）。对9名年龄匹配的对照受试者进行了方法学验证。
通过体外红细胞转酮醇酶活性测定法对硫胺素状态进行生化评估。通过半定量食物频率问卷评估硫胺素的饮食摄入量。
采用Fisher精确检验和逻辑回归来评估硫胺素状态与感兴趣变量之间的关系。
38名患者中有8名（21%）存在硫胺素缺乏的生化证据。38名患者中有10名（25%）存在饮食中硫胺素摄入不足风险的证据。8名有硫胺素缺乏生化证据的患者中有7名符合饮食充足的研究标准，尽管定量数据表明只有4名患者达到了推荐膳食摄入量的三分之二。硫胺素缺乏的生化证据在左心室射血分数低的患者中往往更常见（P=0.07）。
相当一部分充血性心力衰竭患者可能发生硫胺素缺乏，饮食摄入不足可能会增加风险。
