METHODS: Patients who were diagnosed as hypervolemia and treated with intravenous furosemide (at least 40mg/day) were included in this prospective observational study. Whole blood thiamine concentrations were measured 3 times during hospital follow-up of patients.
RESULTS: We evaluated 61 hospitalized hypervolemic patients, of which 22 (36%) were men and 39 (64%) were women, with a mean age of 69.00±10.39 (45-90) years. The baseline and post-hospital admission days 2 and 4 mean thiamine levels were 51.71±20.66ng/ml, 47.64±15.43ng/ml and 43.78±16.20ng/ml, respectively. Thiamine levels of the hypervolemic patients decreased significantly during the hospital stay while furosemide treatment was continuing (p=0.029). There was a significant decrease in thiamine levels in patients who had HF (p=0.026) and also, thiamine was significantly lower in HF patients who had previously used oral furosemide before hospitalization. However, these findings were not present in patients with RF.
CONCLUSIONS: Thiamine substantially decreases in most hypervolemic patients receiving intravenous furosemide treatment during the hospital stay. Thiamine levels were significantly decreased with furosemide treatment in especially HF patients, but the decrease in thiamine levels did not detected at the same rate in RF patients. Diuretic-induced thiamine loss may be less likely in RF patients, probably due to a reduction in excretion.
方法:被诊断为高血容量并接受静脉注射呋塞米(至少40mg/天)治疗的患者被纳入这项前瞻性观察研究。在患者的医院随访期间测量全血硫胺素浓度3次。
结果:我们评估了61例住院的高血容量患者,其中22名(36%)是男性,39名(64%)是女性,平均年龄69.00±10.39(45-90)岁。基线和入院后第2天和第4天的平均硫胺素水平为51.71±20.66ng/ml,47.64±15.43ng/ml和43.78±16.20ng/ml,分别。高血容量患者的硫胺素水平在住院期间显着下降,而呋塞米治疗仍在继续(p=0.029)。有一个显着降低硫胺素水平的患者谁有HF(p=0.026),在住院前曾口服呋塞米的HF患者中,硫胺素显著降低.然而,这些发现在RF患者中不存在.
结论:在住院期间接受静脉呋塞米治疗的大多数高血容量患者中,硫胺素显著降低。硫胺素水平显著降低与呋塞米治疗特别是HF患者,但是在RF患者中,硫胺素水平的下降并没有以同样的速度检测到.利尿剂诱导的硫胺素丢失可能不太可能在RF患者,可能是由于排泄减少.