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首页> 外文学位 >Prospective evaluation of serum vitamin B12 levels in patients receiving long-term lansoprazole for gastroesophageal reflux disease.
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Prospective evaluation of serum vitamin B12 levels in patients receiving long-term lansoprazole for gastroesophageal reflux disease.

机译：长期接受兰索拉唑治疗胃食管反流病患者的血清维生素B12水平的前瞻性评估。

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摘要

Objective. To determine whether long-term lansoprazole therapy (≥9 months) in veteran patients diagnosed with GERD is associated with decreased serum vitamin B12 levels, compared with an age-matched veteran cohort of patients without GERD. If a significant difference in serum vitamin B12 levels between groups is detected, this study would also determine whether serum vitamin B12 levels should be monitored periodically and/or if cobalamin supplementation is warranted in either group.;Methods. Forty male patients, over 50 years of age, from the New York Veterans Administration Medical Center (NYVAMC) ambulatory care clinic were prospectively enrolled and evaluated. Twenty patients were receiving lansoprazole 30 mg/d for maintenance of chronic GERD. The age-matched cohort (n = 20) did not have GERD, nor were they receiving any chronic acid suppressive therapy. Patients were excluded if they had any of the following: anemia, gastric surgery, liver disease, pancreatic insufficiency, intestinal disease, documented alcoholism, excessive alcohol consumption (e.g., ≥3 alcoholic beverages/d), malnutrition, cancer, or HIV. Patients were also excluded if they were receiving vitamins containing B12, drugs known to decrease B12 levels, or who were vegan-vegetarians. Patients who were scheduled to be in the outpatient clinic were identified via computer records, and assessed for study eligibility. Serum vitamin B12, folate, and complete blood counts were obtained for analysis. The reference interval for vitamin B12 used was >187--1059 pg/mL and B 12 deficiency was classified as <157 pg/mL. Upon enrollment into the study, patients were assessed for clinical manifestations of B12 deficiency by their physician.;Results. The mean (+/-SD) age of patients was 62.7 +/- 6.57 years and 64.7 +/- 8.13 years in the lansoprazole and control groups, respectively. The mean (+/-SD) duration of lansoprazole therapy was 19.2 +/- 4.13 months. There was an apparently small, but statistically insignificant, difference in serum vitamin B12 levels between each group. The mean (+/-SD) serum B12 levels were 305.7 +/- 50.63 and 337.5 +/- 76.11 in the lansoprazole and control groups, respectively; p = 0.065, Student's-t test. Serum B12 levels were within the normal range in all patients under investigation. There were no significant differences in serum folate, hemoglobin, and hematocrit between the two groups. No participant had signs, symptoms, or laboratory abnormalities consistent with anemia of any etiology.;Conclusion. Long-term lansoprazole therapy is associated with a small, but statistically insignificant, decline in cobalamin levels. Whether this is a trend remains to be demonstrated through further study with a larger sample size and a longer duration of follow-up. Periodic B12 monitoring and supplementation may still be warranted in select patients who may be at risk for cobalamin deficiency such as the elderly or malnourished.
机译：目的。与年龄匹配的无GERD的退伍军人队列相比，要确定长期被兰索拉唑治疗（≥9个月）的确诊为GERD的退伍军人患者是否与血清维生素B12水平降低相关。如果检测到两组之间的血清维生素B12水平存在显着差异，则本研究还将确定是否应定期监测血清维生素B12水平和/或在两组中是否都需要补充钴胺素。前瞻性招募和评估了纽约退伍军人管理局医疗中心（NYVAMC）门诊诊所的40名50岁以上的男性患者。 20名患者接受兰索拉唑30 mg / d维持慢性GERD。年龄匹配的人群（n = 20）没有GERD，也没有接受任何慢性酸抑制疗法。患有以下情况的患者被排除在外：贫血，胃外科手术，肝病，胰腺功能不全，肠道疾病，有记载的酒精中毒，过量饮酒（例如每天≥3种酒精饮料），营养不良，癌症或HIV。如果患者正在接受含有B12的维生素，已知会降低B12水平的药物或纯素食者，则也被排除在外。通过计算机记录识别计划在门诊就诊的患者，并评估其研究资格。获得血清维生素B12，叶酸和全血细胞计数进行分析。维生素B12的参考间隔为> 187--1059 pg / mL，B 12缺乏症分类为<157 pg / mL。纳入研究后，医师对其患者进行了B12缺乏症临床表现的评估。兰索拉唑组和对照组的患者平均（+/- SD）年龄分别为62.7 +/- 6.57岁和64.7 +/- 8.13岁。兰索拉唑治疗的平均持续时间为19.2 +/- 4.13个月。每组之间的血清维生素B12水平差异很小，但在统计学上不明显。兰索拉唑和对照组的平均血清B12水平分别为305.7 +/- 50.63和337.5 +/- 76.11。 p = 0.065，学生t检验。所有接受调查的患者血清B12水平均在正常范围内。两组之间的血清叶酸，血红蛋白和血细胞比容无显着差异。没有参与者出现与任何病因性贫血相符的体征，症状或实验室异常。长期兰索拉唑治疗与钴胺素水平的下降有关，但在统计学上微不足道。这是否是一种趋势仍有待进一步研究，以更大的样本量和更长的随访时间来证明。对于某些可能存在钴胺素缺乏症的风险的患者，例如老年人或营养不良的患者，仍应定期进行B12监测和补充。

著录项

  • 作者

    Sotiriou, Christopher Gus.;

  • 作者单位

    Long Island University, The Brooklyn Center.;

  • 授予单位 Long Island University, The Brooklyn Center.;
  • 学科 Pharmaceutical sciences.;Medicine.;Pharmacology.
  • 学位 Pharm.D.
  • 年度 2000
  • 页码 59 p.
  • 总页数 59
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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