维生素B12缺乏儿童的神经系统表现:一项前瞻性观察研究

B. Dave, Sonam Sharma
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摘要

背景与目的:维生素B12缺乏儿童常见的神经学表现。本研究确定了拉贾斯坦邦三级保健中心维生素B12缺乏儿童的神经系统表现。方法:经机构伦理委员会(IEC)批准,本观察性分析研究在焦特布尔s.n.医学院儿科进行。研究人群包括2019年9月至2020年8月期间维生素B12缺乏症(<250皮克/分升)的儿童。对儿科病房收治的所有6个月至5岁的贫血儿童(根据世卫组织标准Hb< 11 gm/dl)进行血清维生素B12水平筛查,其中血清维生素B12水平<250Pg/dl的儿童被纳入研究。结果:半数以上(63.8%)患儿年龄在6 ~ 15月龄。男女比例为1.58:1。78.7%来自农村,60%来自较低的社会经济阶层。85%的儿童家庭有素食习惯。最常见的临床特征是指节和皮肤色素沉着(各占85%),其次是色素沉着和稀疏的头发(70%),以及胖乎乎的脸(42.5%)。65%的儿童被发现有神经症状。最常见的神经学表现为发育迟缓(60%),其次是张力低下(38.7%)、反射过度(31.2%)和运动异常(20%)。结论:迫切需要对儿童进行早期评估,以防止进一步阻止儿童的发育性生长。关键词:神经学表现,维生素B12,发育迟缓
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Neurological Manifestations in Vitamin B12 Deficient Children: A Prospective Observational Study
Background and aim: Neurological manifestations in vitamin B12 deficient children in common. The present study determined neurological manifestations in vitamin B12 deficient children in a tertiary care centre in Rajasthan. Methods: This hospital based observational analytical study was conducted in Department of Pediatrics, Dr. S. N. Medical College, Jodhpur after approval of Institutional Ethics Committee (IEC). The study population included Vitamin B12 deficient (<250 picogram/dl) children during September 2019 to August 2020. All children aged 6 months to 5 years admitted in pediatric ward with anaemia (Hb< 11 gm/dl according to WHO Criteria) were screened for serum vitamin B12 levels out of which children having serum vitamin B12 level <250Pg/dl were included in the study. Results: More than half (63.8%) of the children aged between 6 months and 15 months. Male to female ratio was 1.58:1. 78.7% were rural and 60% were from lower socioeconomic class. 85% of the children’ family had vegetarian dietary habits. The most common clinical feature was hyperpigmentation of knuckles and skin (85% each) followed by depigmented and sparse hair (70%), and chubby face (42.5%). 65% of the children were found to have neurological manifestations. The most common neurological manifestation was developmental delay (60%) followed by hypotonia (38.7%), exaggerated reflexes (31.2%), and abnormal movements (20%). Conclusion: There is an urgent demand for early evaluation of the children so prevent further prevent developmental growth of the children. Keywords: Neurological manifestations, vitamin B12, developmental delay
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