维生素B12并阿米替林治疗抑郁症临床研究

为探讨维生素B12并阿米替林治疗抑郁症的疗效，作者将抑郁症患者随机分为维生素B12并阿米替林组和阿米替林组进行疗效对照研究，结果显示维生素B12并阿米替林治疗效果明显，见效时间明显快于阿米替林，副作用少，特别是对预防自杀有极为显著的疗效。     

维生素B12的秘密

据美国BIOCOMPARE科技新闻网（2006／2／23）报道，数十年来，科学家一直很想知道生物如何制造基本的维生素B12。现在，研究人员利用洗衣店里的漂白剂和土中的细菌，找到了解决这个奥秘所需的重要线索。     

去甲文拉法辛对严重抑郁症治疗有效

美国康涅狄格大学医学院的Nicholas A，DeMartinis博士及其同事在5月的《临床精神病学杂志》（J Clin Psychiatry，2007；68：677—688．）上报道，去甲文拉法辛（Desvenlafaxine）短期治疗严重抑郁症有效。     

老年性痴呆血清维生素B12及叶酸水平

我国已步入老龄社会，老年病防治逐渐引起关注。老年性痴呆的发病与体内维生素B12(VitB12)及叶酸(FA)水平是否存在某种联系，国外文献说法不一，国内尚来见报道．我们测定了临床诊断为阿尔采默氏病(Alzheimer’s disease，AD)11例，脑血管性痴呆(多发性梗塞痴呆Multi-infarct dementia，MID)33例的血清VitB12及FA含量，     

贫困地区18月龄幼儿维生素B_（12）营养状况与膳食的相关性

目的了解中国贫困地区18月龄幼儿的维生素B12（VB12）营养状况,以及不同食物干预对幼儿VB12营养状况的影响。方法研究对象来自于一项婴儿辅食的随机对照干预研究。研究对象于6月龄时入组,分别给予免费肉类、强化米粉、普通米粉进行干预,随访至18月龄;18月龄时采集静脉血检测血清VB12、同型半胱氨酸（tHcy）、Hb等,并测量体格生长指标。结果共入选217名18月龄幼儿,其中肉类干预组61名,强化米粉干预组85名,普通米粉干预组71名。217名幼儿的VB12中位数为342（85-2700）pg·mL-1,tHcy中位数为8.20（3.30-20.40）μmol·L-1,Hb中位数为124（90-158）g·L-1。85名（39.2%）VB12〈300pg·mL-1,42名（19.4%）〈200pg·mL-1;26名（12.0%）tHcy〉12μmol·L-1;52名（24.0%）Hb〈115g·L-1。肉类干预组、强化米粉干预组和普通米粉干预组VB12中位数分别为335、422和281pg·mL-1,3组间差异有统计学意义（P=0.013）;3组VB12〈300pg·mL-1的比例分别为肉类干预组39.4%（24名）、强化米粉干预组28.2%（24名）、普通米粉干预组52.1%（37名）,3组间差异有统计学意义（P=0.010）。结论贫困地区幼儿VB12缺乏较普遍,与膳食中VB12摄入不足有关,强化米粉和肉类等干预有助于改善幼儿VB12营养状况。     

胃溃疡患者血清叶酸,维生素B12检测的临床意义

叶酸、维生素B_(12)为人体不可缺少的造血元素之一。这些元素只有在食品中获得,其吸收主要取决于胃粘膜结构及功能的正常、肝脏功能的正常和肠肝循环的正常。以上器官功能受损均可影响到血清叶酸和维生素B_(12)浓度。为此,我们对38例胃溃疡患者进行了血清叶酸和维生素B_(12)浓度的测定,现将结果报告如下。     

肝硬化患者血清叶酸、维生素B12检测的临床意义

我们对６２例肝硬化患者进行了血清叶酸和维生素Ｂ１２浓度的测定 ,现将结果报告如下。对象和方法一、对象 :（一）正常人 :３５人。均为我院预防保健科体检合格的健康人 ,心、肝、肺、肾等重要脏器无疾患 ,肝肾功能试验正常 ,并相应排除血液系统疾患。（二）病人组 :６２人（男４１ ,女２１） ,均为临床上明确诊断的肝硬化患者 ,其中肝硬化无腹水者３６人 ,肝硬化有腹水者２６人 ,全部病例均经Ｂ超、ＣＴ和实验室肝纤维化检测项目明确诊断 ,部分病例经核磁共振和病理检查明确诊断 ,年龄２８～６４岁 ,平均４６．５岁。二、方法 :（一）标本…     

肺结核病人血清叶酸和维生素B12的含量变化

肺结核病人血清叶酸和维生素Ｂ_（１２）的含量变化叶一秀，王仲元，王巍，李世平，王安生血清叶酸（ＦＡ）和ＶＢ（１２）ＲＩＡ测定已用于血液病、尿毒症等疾病的诊治［１，２］，但有关肺结核病人血清ＦＡ和ＶＢ（１２）含量变化的报告很少。为此我们对肺结核病人血清?..     

白血病患者血清叶酸,维生素B12RIA

我们采用放射免疫分析法测定62例白血病患者血清叶酸(FA)及维生素B_(12)(VB_(12))含量,以探讨其含量的变化在白血病患者病情监测中的意义。 材料和方法 一、对象:白血病患者共62例(男27,女35),经血象、骨髓象及组织化学染色等检查均符合白血病诊断。年龄19～81岁,平均47岁。其中初治急性白血病(AL)30例(M_13例,M_24例,M_36例,M_45例,M_55例,ALL7例);缓解期AL13例(M_21例,M_33例,M_44例,M_52例、ALL3例);复发期AL患者7例(M_22例,M_32例,M_42例,ALL1例);慢性粒细胞性白血病(CML)12例,另设正常对照组32例(男14,女18),年龄21～56岁,平均37岁,均为在我院体检健康者。 二、方法:空腹取静脉血2ml分离血清,采用固相非煮沸双向标记免疫分析测定法,由美国Diagnostic Procluct公司提供的FA及VB_(12)放射免疫分析试剂盒,按说明书操作。用芬兰产WIA型全自动微电脑γ计数器测定。 三、统计学处理:采用线性相关分析,t检验。     

血清叶酸、维生素B12水平与阿尔茨海默病的相关性研究

为研究血清叶酸、维生素B12水平与阿尔茨海默病(AD)的关系,用化学发光法检测了77例AD患者和85名正常老年人的血清叶酸、VitB12的浓度.结果表明:AD组血清叶酸和VitB12浓度明显低于对照组(P＜0.05).AD组血清叶酸和VitB12浓度低于正常的例数明显多于对照组.结论:血清叶酸、维生素B12水平与AD有一定联系,但血清叶酸、VitB12水平与AD的严重程度无联系.     

Vitamin B12 deficiency presenting as an acute confusional state: a case report and review of literature

Background

Vitamin B12 deficiency is associated with a wide spectrum of neuro-psychiatric manifestations.

Results

We report a case of a 44 year old female patient referred to the haematology unit with vitamin B12 deficiency presenting as an acute confusional state or delirium. Total resolution of the psychiatric symptoms occurred following parenteral vitamin B12 replacement therapy.

Conclusion

This case report highlights one of the neuro-psychiatric presentations of vitamin B12 deficiency in a previously healthy individual.     

鼻咽癌患者血清同型半胱氨酸与叶酸、维生素B12水平的相关性分析

目的 通过检测鼻咽癌患者血清中同型半胱氨酸(Hcy)、叶酸、维生素B12(VitB12)的水平,探讨其相关性及与鼻咽癌临床分期的关系.方法 收集本院明确诊断的鼻咽癌患者60例,同期健康对照组60例,血清Hcy水平测定采用循环酶法,叶酸、VitB12水平测定采用电化学发光免疫分析法.结果 鼻咽癌组血清Hcy水平显著高于对照组(P＜0.05),叶酸和VitB12水平低于对照组(P＜0.05);血清Hcy、叶酸和VitB12水平与鼻咽癌不同临床分期之间的差异无统计学意义(P＞0.05).结论 血清Hcy、叶酸和VitB12水平与鼻咽癌存在相关性,三者对鼻咽癌的诊疗有一定的临床价值.     

血清叶酸和维生素B12水平与妊娠高血压综合征的相关性探讨

目的通过测定妊娠高血压综合征患者血清叶酸和维生素B12水平,探讨孕妇叶酸、维生素B12水平与妊娠高血压发生的关系。方法选择妊娠高血压孕妇25例,正常孕妇30名,正常非妊娠体检女性35名,采用化学发光免疫分析技术（CLIA）测定每组叶酸和维生素B12水平,比较各组之间的差异。结果正常孕妇组叶酸和维生素B12水平与正常体检女性组无明显差异,妊高症患者组叶酸及维生素B12水平均明显低于其他两组（P〈0.05）。结论孕妇血清叶酸和维生素B12水平可作为妊高症的预测指标,与妊高症的发生有较好的相关性。     

Vitamin B12 deficit and development of geriatric syndromes

Vitamin B12 deficiency or cyanocobalamin is a common condition in the elderly. It is repeatedly overlooked due to multiple clinical manifestations that can affect the blood, neurological, gastrointestinal, and cardiovascular systems, skin and mucous membranes. The various presentations of vitamin B12 deficiency are related to the development of geriatric syndromes like frailty, falls, cognitive impairment, and geriatric nutritional syndromes like protein-energy malnutrition and failure to thrive, in addition to enhancing aging anorexia and cachexia. Therefore, interventions must be developed to include their screening and diagnosis to make early and appropriate treatment to prevent its complications before they become irreversible.     

血清维生素B12和叶酸浓度测定在脑血管疾病中的临床意义

为了研究脑血管疾病患者血清维生素B12和叶酸检测的临床意义, 用放射免疫分析法测定32例脑血管疾病患者血清VitB12和叶酸的水平. 结果发现, 叶酸在所有观察组中变化无显著差异; 多脑梗塞痴呆组VitB12水平(217.2±135.9pmol/L)明显低于脑梗塞组(416.1±184.9pmol/L)和脑出血组(458.4±127.4pmol/L);瘫痪肌力为0-Ⅲ级者VitB12水平较低.因此VitB12水平降低与智能障碍和瘫痪程度有关.     

Vitamin B12 and folic acid deficiency in chronic pancreatitis: a relevant disorder?

Summary Vitamin B12 malabsorption was reported earlier to occur in patients with exocrine pancreatic insufficiency, and pancreatic extracts were shown to improve the absorption of vitamin B12. We investigated serum levels of vitamin B12 and serum folate in patients with chronic pancreatitis and different degrees of pancreatic insufficiency.137 patients (84 males, 53 females, age 34–72 years) with chronic pancreatitis (C.P.) were included in the study. 123 of 137 (89.8%) patients had a pathologic pancreatic function test result, classified into mild (n=24), moderate (n=61) or severe (n=38) insufficiency. The normal range of serum vitamin B12 and folic acid was established in 58 healthy controls and was found to be 190–1020 pg/ml for serum vitamin B12 and 2.4–16.1 ng/ml for folic acid. 7 patients (5.7%) with C.P. had vitamin B12 serum levels below 190 pg/ml; 4 of these had severe and 3 had mild or moderate exocrine pancreatic insufficiency. However there was no overall correlation between the degree of pancreatic insufficiency and vitamin B12 values. Serum levels of Vitamin B12 were 512±48 pg/ml in mild, 493±52 pg/ml in moderate and 428±45 pg/ml in severe exocrine insufficiency. Serum folic acid below 2.4 ng/ml were present in 5 patients (3.6%). Folic acid serum levels were 8.34±0.76 ng/ml in mild, 6.34±0.52 ng/ml in moderate and 7.45±0.53 ng/ml in severe exocrine insufficiency. We conclude that vitamin B12 deficiency is a rare finding in chronic pancreatitis and does not strictly depend on the degree of exocrine pancreatic insufficiency. In clinical practice enzyme supplementation in patients with severe pancreatic insufficiency is obviously sufficient for normal vitamin B12 absorption. Folic acid deficiency is also unfrequently found in chronic pancreatitis.     

音乐辅助治疗对抑郁症患者所伴发躯体疼痛症状的疗效

目的探讨音乐治疗对抑郁症患者所伴发躯体疼痛症状的辅助治疗作用。方法伴有躯体疼痛症状的抑郁症患者随机分组,分别接受帕罗西汀联合音乐治疗(音疗组,n=40)或单一帕罗西汀治疗(对照组,n=40)。于治疗前、治疗后2周末、4周末,分别以视觉模拟评分量表(VAS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评定疼痛、抑郁、焦虑的严重程度。结果①音疗组、对照组治疗后2、4周末时,SDS、SAS均较治疗前显著下降(t=3.517~5.664,P均0.001);治疗后4周末时,两组VAS评分也较治疗前显著下降(分别t=3.507、2.158,P0.01、0.05);②音疗组治疗4周末的VAS、SAS评分的变化值均显著高于对照组,差异有统计学意义(t=2.093、2.458,P均0.05);③音疗组、对照组的治疗前、治疗后2周末、4周末VAS评分,与SDS、SAS评分均正相关(r=0.329~0.464,P0.05~0.01);2周末的VAS评分变化值与SDS评分变化值正相关(r=0.408、0.343,P0.05);4周末的VAS评分变化值与SAS评分变化值正相关(r=0.484、0.395,P0.01、0.05)。结论音乐治疗对抑郁症患者伴发的躯体疼痛症状有一定的辅助治疗作用。     

抑郁症患者的情绪冲突研究

目的:应用情绪启动范式考察抑郁症患者情绪冲突的异常。方法:对20例抑郁症患者和18名在年龄、受教育程度等方面相匹配的对照组,进行了情绪启动实验,启动刺激为积极词、一般消极词和抑郁相关词,目标刺激为积极和消极人脸,要求判断人脸的情绪类型。还对所有被试进行了贝克抑郁问卷(BDI)和状态-特质焦虑问卷(STAT)的测查。结果:在抑郁组和对照组均发现了显著的一般情绪冲突效应(由一般消极词导致);在抑郁组身上还发现,当目标人脸为积极表情时,由抑郁相关词导致的特殊情绪冲突效应,显著大于一般消极词导致的情绪冲突效应,而这种差异在正常控制组身上却没有发现。回归分析的结果进一步表明,抑郁相关词导致的情绪冲突效应与BDI分数具有线性相关关系。结论:抑郁症患者在情绪冲突上不同于正常人的异常表现,可能跟他们的注意偏向有关。     

The schilling test cannot be replaced by an absorption test with unlabeled vitamin B12

Summary It was the purpose of this study to evaluate the diagnostic usefulness of an oral absorption test using nonlabeled Vit B12 suggested by a commercial distributor as an alternative for the more expensive Schilling test (ST). Plasma levels of Vit B12 were measured with a commercial kit before and 4 h after oral administration of 1 mg Vit B12 in 32 normals, in 16 patients with normal ST, and in 14 patients with abnormal ST for determination of sensitivity and specificity with the ST as golden standard. In normals, a mean of 767±404 pg/ml before and 1096±776 pg/ml after oral Vit B12 with a mean increase of 331±453 pg/ml was measured. Because of the obvious large variation, no meaningful range for normal absorption could be established. In the two patient subsets, there was no Gaussian distribution of the results, with a meridian of Vit B12 increase after absorption of 142 pg/ml, range 27–2668 pg/ml, in the group with normal ST and a meridian of 244 pg/ml ranging from 40 to 2453 pg/ml in the group with abnormal ST. Statistical nonparametric analysis did not reveal any difference between the two groups. Assuming a minimum required increase of 100 pg/ml, as suggested by the kit distributor, a sensitivity of only 27% and a specificity of 75% was obtained. The lack of any diagnostic value of this approach might be caused by the known nonintrinsic-factor mediated absorption of approximately 1% of any B12 given orally even in complete intrinsic factor deficiency and by the relatively large amount of oral Vit B12 needed for a cold absorption test. The latter can, thus, not replace the Schilling test.Abbreviations Vit B12 Vitamin B12