Martin D C
Section of Geriatric Medicine, University of Pittsburgh School of Medicine, Pennsylvania.
Clin Geriatr Med. 1988 Nov;4(4):841-52.
Both B12 and folate deficiency have been linked to a dementia syndrome. In the case of B12, the neurologic sequelae may precede the hematologic by months to years. Treating a B12 deficient patient with folate or conversely a folate deficient patient with B12 may exacerbate the neurologic consequences of either deficiency. Iron deficiency is a frequent concomitant of both B12 and folate deficiency, often developing during replacement therapy. Patients with borderline B12 deficiency states have shown biochemical evidence of megaloblastosis and B12 replacement is recommended for those patients.
维生素B12和叶酸缺乏均与一种痴呆综合征有关。就维生素B12而言，神经后遗症可能比血液学异常早数月至数年出现。用叶酸治疗维生素B12缺乏的患者，或者相反，用维生素B12治疗叶酸缺乏的患者，可能会加重任何一种缺乏的神经后果。缺铁是维生素B12和叶酸缺乏常见的伴随情况，常在替代治疗期间出现。维生素B12临界缺乏状态的患者已显示出巨幼细胞贫血的生化证据，建议对这些患者进行维生素B12补充治疗。
