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[维生素B12在老年人认知障碍治疗与预防中的应用]

[Vitamin B12 in the treatment and prevention of cognitive disorders in the elderly].

作者信息

Cherdak M A, Mkhitaryan E A, Zakharov V V, Voznesenskiy N A

机构信息

Pirogov Russian National Research Medical University, Russian Clinical and Research Center of Gerontology, Moscow, Russia.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(1):43-49. doi: 10.17116/jnevro202212201143.

Abstract

Vitamin B (cobalamin) deficiency is a common condition in the elderly. Contrary to the established point of view, the absence of hematological changes (macrocytic anemia) does not always necessarily exclude this condition. Damage of the nervous system with the development of a complex of neurological and mental disorders is observed even at borderline levels of vitamin in blood. It is known, that vitamin deficiency is important risk factor of dementia. Cobalamin deficiency can directly lead to cognitive damage or accelerate development of dementia due to the other brain pathology - Alzheimer's disease, vascular dementia. The review provides information on the biological role of cobalamin in the human body, the prevalence of vitamin deficiency, especially in the elderly patients, and methods of its diagnosis and management. Both traditional parenteral therapy regimens and the possibility of oral intake of cobalamin in the course of deficiency correction are discussed.

摘要

维生素B(钴胺素)缺乏在老年人中是一种常见情况。与既定观点相反,血液学变化(巨细胞性贫血)的缺失并不总是必然排除这种情况。即使在血液中维生素处于临界水平时,也会观察到神经系统损伤并伴有一系列神经和精神障碍。众所周知,维生素缺乏是痴呆的重要风险因素。钴胺素缺乏可直接导致认知损害,或由于其他脑部病变——阿尔茨海默病、血管性痴呆而加速痴呆的发展。本综述提供了关于钴胺素在人体中的生物学作用、维生素缺乏的患病率,尤其是老年患者中的患病率,以及其诊断和管理方法的信息。文中还讨论了传统的肠外治疗方案以及在纠正缺乏过程中口服钴胺素的可能性。

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