Bahadir Aysenur, Reis Pınar Gökçe, Erduran Erol
School of Medicine, Department of Pediatric Hematology, Karadeniz Technical University, Trabzon, Turkey.
J Paediatr Child Health. 2014 Sep;50(9):721-5. doi: 10.1111/jpc.12652. Epub 2014 Jun 18.
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.
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).
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).
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.
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。
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）。
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）。
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。
