使用经体内57Co-钴胺素标记的鱼肉对老年人蛋白质结合型维生素B12（钴胺素）吸收不良进行前瞻性评估。
Prospective evaluation of protein bound vitamin B12 (cobalamin) malabsorption in the elderly using trout flesh labelled in vivo with 57Co-cobalamin.
作者信息
Aimone-Gastin I, Pierson H, Jeandel C, Bronowicki J P, Plénat F, Lambert D, Nabet-Belleville F, Guéant J L
机构信息
Laboratory of Cellular and Molecular Pathology in Nutrition, EP CNRS 0616, Faculté de Médecine, Vandoeuvre-lès-Nancy, France.
出版信息
Gut. 1997 Oct;41(4):475-9. doi: 10.1136/gut.41.4.475.
BACKGROUND
The frequency of dietary protein bound vitamin B12 malabsorption in elderly patients remains controversial.
AIMS
To evaluate this malabsorption in elderly hospitalised patients using a modified Schilling test.
PATIENTS
Fourteen elderly patients with low B12 blood levels were prospectively selected from 394 hospitalised patients.
METHODS
The modified Schilling test was performed with trout labelled in vivo.
RESULTS
The test was normal in five healthy elderly subjects, in 7/8 patients with pancreatic insufficiency, and in nine non-elderly patients with antral gastritis. The low decision limit was established at 3.3% (median 4.8%). From the 14 elderly patients with low B12 prospectively selected from 394 hospitalised patients, seven had a real deficiency with anaemia and an increased homocysteine and/or methylmalonate serum level. The modified Schilling test showed malabsorption in five of these patients, including two in which the standard Schilling test was normal, and three in which the standard Schilling test was partially corrected by an intrinsic factor.
CONCLUSIONS
Protein bound vitamin B12 malabsorption was detected in at least 0.5% of elderly hospitalised patients, using the labelled trout flesh absorption test.
背景
老年患者中膳食蛋白结合型维生素B12吸收不良的发生率仍存在争议。
目的
使用改良的希林试验评估老年住院患者的这种吸收不良情况。
患者
从394名住院患者中前瞻性地选取了14名维生素B12血水平较低的老年患者。
方法
采用体内标记的鳟鱼进行改良的希林试验。
结果
5名健康老年受试者、7/8名胰腺功能不全患者以及9名非老年胃窦炎患者的试验结果正常。低判定界限设定为3.3%（中位数为4.8%）。在从394名住院患者中前瞻性选取的14名维生素B12水平较低的老年患者中，7名存在真正的缺乏，伴有贫血以及血清同型半胱氨酸和/或甲基丙二酸水平升高。改良的希林试验显示其中5名患者存在吸收不良，包括2名标准希林试验结果正常的患者，以及3名标准希林试验通过内因子部分纠正的患者。
结论
使用标记鳟鱼肉吸收试验，在至少0.5%的老年住院患者中检测到了蛋白结合型维生素B12吸收不良。
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