Katar Selahattin, Nuri Ozbek Mehmet, Yaramiş Ahmet, Ecer Sultan
Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
J Pediatr Hematol Oncol. 2006 Sep;28(9):559-62. doi: 10.1097/01.mph.0000212958.89091.c0.
We aimed to investigate the presence of psychomotor retardation, physical and laboratory examination in infants with megaloblastic anemia. Inclusion criteria for the study were; age 9 to 36 months, refusal of food except for breast and cow milk, loss of appetite, developmental delay, significant pallor, and hypersegmentation neutrophils in the peripheral blood smear. A total of 33 children fulfilling the inclusion criteria were enrolled among 3368 patients attending Pediatric Outpatient Clinics of şirnak-Cizre State Hospital between January 25, 2004 and May 5, 2004. Mean age was 16.4 months. Thirty-two patients had Vitamin B12 deficiency, 1 patient had folate deficiency, and 10 patients had combined vitamin B12 and folate deficiency. Statistically, a positive significant relationship was detected between serum vitamin B12 levels and mean corpuscular volume (P = 0.001, r = 0.56), and between vitamin B12 levels and hemoglobin (P = 0.004, r = 0.49). We believe that preventative measures such as fortification of flour with vitamin B12, nutritional support with vitamin B12 for the mother during pregnancy and nursing, provision of adequate primary preventive health services, and starting complementary food after 6 months of age are important determinants for preventing megaloblastic anemia.
我们旨在调查巨幼细胞贫血婴儿的精神运动发育迟缓情况、体格检查及实验室检查结果。本研究的纳入标准为:年龄9至36个月、除母乳和牛奶外拒食、食欲不振、发育迟缓、显著苍白以及外周血涂片出现中性粒细胞核分叶过多。在2004年1月25日至2004年5月5日期间,锡尔纳克-锡兹雷州立医院儿科门诊的3368例患者中,共有33名符合纳入标准的儿童入组。平均年龄为16.4个月。32例患者存在维生素B12缺乏,1例患者存在叶酸缺乏,10例患者存在维生素B12和叶酸联合缺乏。统计学分析显示,血清维生素B12水平与平均红细胞体积之间存在显著正相关(P = 0.001,r = 0.56),维生素B12水平与血红蛋白之间也存在显著正相关(P = 0.004,r = 0.49)。我们认为,诸如用维生素B12强化面粉、孕期和哺乳期母亲给予维生素B12营养支持、提供充足的一级预防保健服务以及6个月龄后开始添加辅食等预防措施,是预防巨幼细胞贫血的重要决定因素。