当时间是大脑时:关于沃尼克脑病的系统性审查,因为胺缺乏症的戏剧性后果在hyperemesis gravidarum中
Marta Fiorentini1, Bianca Nedu1, Fabrizio Dapoto1
1Obstetric Unit, Department of Medical and Surgical Sciences, University of Bologna and IRCCS Azienda Ospedaliero- Universitaria S.Orsola-Malpighi, Bologna, Italy.
概括
妊娠激增 (HG) 可能导致沃尼克脑病 (WE),这是由于胺缺乏症引起的严重疾病. 在孕妇中迅速诊断和治疗WE至关重要,以防止不可逆转的神经损伤.
科学领域:
- 神经学 神经学
- 产科 产科 产科 产科 产科
- 营养科学 营养科学
背景情况:
- 妊娠中症 (HG) 影响高达80%的怀孕,有时严重.
- HG是维尼克脑病变 (WE) 的潜在诱导因素,维尼克脑病是危及生命的胺缺乏症.
- 未经治疗,WE可以发展为不可逆转的认知障碍 (科萨科夫综合征).
研究的目的:
- 调查临床表现,孕产妇和产周结局,以及怀孕个体HG的WE的治疗.
- 审查现有文献,并报告与HG相关的WE病例.
主要方法:
- 从Medline (开始至2021年12月) 系统审查病例系列和报告.
- 搜索术语包括"韦尼克脑病变"",妊娠过度","怀孕"和"胺缺乏症".
- 包括文章描述了与HG相关的胺缺乏症导致的至少一个WE病例,总共来自66份手稿的82例.
主要成果:
- 分析了82例怀孕期间HG引起的WE病例.
- 常见的症状包括眼部症状 (93.9%),心动 (74.4%),困惑 (76.8%) 和记忆障碍 (30.5%).
- 提氨酸的使用是常见的,但关于神经过程和围产期结果的数据往往是缺失的或异质的.
结论:
- 怀孕时的WE诊断是具有挑战性的,因为非特异性症状.
- 高度的临床怀疑和对HG作为诱导因素的认识对于及时诊断至关重要.
- 早期开始治疗对于预防可能危及生命的神经系统后果至关重要.
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