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首页> 外文期刊>BMJ: British medical journal >Consider non-invasive follow-up and malabsorption in old age
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Consider non-invasive follow-up and malabsorption in old age

机译：考虑非侵入性的跟踪和吸收不良在年老时

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摘要

Hudson describes the classic clinical signs of vitamin B-12 deficiency in an elderly patient and recommends traditional diagnostic procedures such as measuring vitamin B-12 values and determining antibodies against intrinsic factor and parietal cells.1 However, newer non-invasive, functional blood tests such as measurement of total homocysteine, methylmalonic acid, and holo-transcobalamin II values would allow confirmation of the clinical diagnosis and even monitoring of the early response to treatment.Hudson focuses primarily on pernicious anaemia as the most likely cause of vitamin B-12 deficiency in elderly people. However, malabsorption of vitamin B-12 in food, which is closely associated with atrophic gastritis-a condition with a high prevalence in elderly people-may be the leading cause (in 60-70% of cases) of mild vitamin B-12 deficiency.3 Long term atrophic gastritis may not only be associated with impaired ability to release vitamin B-12 from food products or its binding proteins but may also cause impaired iron absorption.4 Awareness of the association between malabsorption ofvitamin B-12 in food and impaired iron absorption is therefore clinically important, and iron status should. be monitored during supplementation with vitamin B-12. Indeed, a rapid haematological response to vitamin B-12 supplementation may result in rapid depletion of iron stores.
机译：哈德逊描述的典型临床症状在一个上了年纪的病人和维生素b - 12缺乏建议这样的传统诊断程序测量维生素b - 12的价值观和判断内因子抗体和顶叶cells.1血液测试测量等同型半胱氨酸、methylmalonic酸和将允许holo-transcobalamin二值临床诊断和确认监测早期的回应治疗。维生素b - 12的贫血,最可能的原因在老年人缺乏。是吸收不良食品中维生素b - 12与萎缩性gastritis-a密切相关条件高患病率的老人人)可能是(在60 - 70%的主要原因例)的维生素b - 12 deficiency.3温和萎缩性胃炎不仅可能与发布能力受损有关维生素b - 12的食品或其绑定蛋白质,但也可能导致受损的铁absorption.4吸收不良食品中富含维生素b - 12和受损铁的吸收因此临床重要的是,和铁状态。在补充维生素b - 12。快速血液学的维生素b - 12补充可能会导致快速损耗的铁商店。

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