维生素B12缺乏的神经后果:系统审查和随机对照试验
Abir Abdalaal Hamza Ali1, Fatima H A Mohamed2, Samir Hago3
1Internal Medicine, Maidstone Hospital, Maidstone, GBR.
Cureus
|June 9, 2025
概括
维生素B12补充剂有效地治疗临床缺乏症患者的神经症状. 然而,对于那些患有亚临床缺陷的人,特别是老年人,它对神经系统有有限的益处.
科学领域:
- 神经学 神经学
- 营养科学 营养科学
背景情况:
- 维生素B12缺乏经常导致神经系统问题,如神经病变和认知能力下降.
- 维生素B12补充剂对神经恢复的有效性,特别是在亚临床缺乏症中,需要进一步研究.
研究的目的:
- 系统地审查对维生素B12补充剂的神经效应的随机对照试验 (RCT).
- 在维生素B12补充研究中评估治疗结果,施用途径和人群特征.
主要方法:
- 对十项随机对照试验 (RCT) 的系统综述.
- 包括的研究集中在临床和亚临床维生素B12缺乏的人身上.
- 分析考虑了神经学结果,施用途径和研究质量.
主要成果:
- 补充维生素B12可以改善明显缺乏维生素B12的患者的神经症状.
- 口服维生素B12的疗效与注射疗效相当,耐受性更好,成本更低.
- 在患有亚临床缺乏症的老年人中,没有观察到显著的认知或神经改善.
- 患有神经病变的糖尿病患者显示症状得分有所改善,但在客观的神经学测量中没有.
- 降低homocysteine并不总是与临床益处相关.
结论:
- 维生素B12补充对临床缺陷有益,但在亚临床病例中显示出有限的神经学益处.
- 口服补充剂是注射的可行和经济有效的替代方案.
- 为了优化维生素B12治疗,需要进一步研究标准化结果和更长的随访时间.
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