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口服维生素B12治疗对营养性维生素B12缺乏的儿童有效。

Oral vitamin B12 treatment is effective for children with nutritional vitamin B12 deficiency.

作者信息

Bahadir Aysenur, Reis Pınar Gökçe, Erduran Erol

机构信息

School of Medicine, Department of Pediatric Hematology, Karadeniz Technical University, Trabzon, Turkey.

出版信息

J Paediatr Child Health. 2014 Sep;50(9):721-5. doi: 10.1111/jpc.12652. Epub 2014 Jun 18.

Abstract

AIM

Despite being one of common preventable deficiency disorders, vitamin B12 (vit-B12) deficiency can lead to serious health problems both in children and adult. The familiar treatment through parenteral route for vit-B12 deficiency frequently leads to poor adherence, and adequate response to treatment has lead to interest in oral supplementation. This study investigates the efficacy of oral vit-B12 treatment in children with nutritional vit-B12 deficiency.

METHODS

Forty-seven children (from 1 month to 17 years) with vit-B12 levels below 200 pg/mL were allocated either of two study groups: Group 1 (1-20 months) and Group 2 (6-17 years) which were subdivided according to the duration of treatment (Group 1A&2A: 4 months; Group 1B&2B: 8 months of 1000 μg oral vit-B12, every day for a week, every other day for 2 weeks, 2 days a week for 2 weeks, then once a week).

RESULTS

Vit-B12 levels among all groups were significantly restored following high oral vit-B12 doses (P = 0.013, P = 0.001), the regimen being more effective in Group1A and Group1B. Correlation analysis of serum vit-B12 levels and age at the end of treatment revealed a decreasing trend with the increasing patient age (corelation respectively -65.2%, P = 0.08; -35.4%; P = 0.25).

CONCLUSION

Data from this study indicate that oral vit-B12 (1000 μg) for 4 months is effective, giving clinicians more choice, for treatment of children with nutritional vit-B12 deficiency. However, despite this high dose, lower levels were achieved in older children indicating the necessity of dosage adjustment in accordance with body weight.

摘要

目的

尽管维生素B12(vit-B12)缺乏是常见的可预防的营养缺乏症之一,但它会在儿童和成人中导致严重的健康问题。针对vit-B12缺乏症通过肠胃外途径进行的常规治疗常常导致依从性差,而对治疗的充分反应引发了人们对口服补充剂的兴趣。本研究调查口服vit-B12治疗营养性vit-B12缺乏症儿童的疗效。

方法

47名vit-B12水平低于200 pg/mL的儿童(年龄从1个月至17岁)被分配到两个研究组中的一组:第1组(1至20个月)和第2组(6至17岁),这两组再根据治疗持续时间细分(第1A组和第2A组:4个月;第1B组和第2B组:8个月,口服1000μg vit-B12,每周1天,持续1周,隔天1次,持续2周,每周2天,持续2周,然后每周1次)。

结果

在口服高剂量vit-B12后,所有组的vit-B12水平均显著恢复(P = 0.013,P = 0.001),该方案在第1A组和第1B组中更有效。治疗结束时血清vit-B12水平与年龄的相关性分析显示,随着患者年龄的增加呈下降趋势(相关性分别为-65.2%,P = 0.08;-35.4%;P = 0.25)。

结论

本研究数据表明,口服vit-B12(1000μg)4个月是有效的,为临床医生治疗营养性vit-B12缺乏症儿童提供了更多选择。然而,尽管剂量很高,但年龄较大的儿童达到的水平较低,这表明有必要根据体重调整剂量。

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