Vitamin B12 Replacement Treatment; Oral? Intramuscular?

Öz

Background: Vitamin B12 deficiency is one of the common diseases in the community which can cause hematological and neurological symptoms and signs. It is usually treated by intramuscular injection after diagnosis. The aim of this study was to compare oral and intramuscular B12 replacement therapy.
Materials and Methods: The study was started with the decision dated 24/07/2013 and numbered 2013-646 of the Scientific Research Evaluation Commission of Ankara Numune Training and Research Hospital. Patients who were admitted to the internal medicine outpatient clinic between May-October 2012 and whom were recently diagnosed with vitamin B12 deficiency, that received oral or intramuscular therapy, and came to the control one month later, were included in the study. Statistical analysis was performed with “SPSS for Windows 20.0” SS package program.
Results: 56 patients with oral vitamin B12 replacement therapy and 46 patients with intramuscular vitamin B12 replacement therapy were found. According to baseline values, significant increase in vitamin B12 levels was observed in all patients. (220.73 ± 243.47 pg / ml, p <0.001). Vitamin B12 increase was 252,91 ± 297,23 pg / ml in oral treatment group and 182,96 ± 152,90 pg / ml in intramuscular treatment group respectively. There were no significant differences between two groups (p> 0.05).
Conclusion: In a study that was divided into oral and intramuscular B12 replacement therapy, an increase in vitamin B12 levels was found with oral and intramuscular treatment after 90 days of treatment, but the groups were not compared in terms of efficacy. In our study, since there was no difference between oral and intramuscular B12 replacement therapies in patients with vitamin B12 deficiency, may suggest that oral replacement therapy may be an alternative to intramuscular therapy. Further comprehensive randomized controlled studies are required to determine the efficiency of intramuscular B12 replacement therapy.

Vitamin B12 Replasman Tedavisi; Oral? İntramüsküler?

Öz

Amaç: Bu çalışmanın amacı intramüsküler B12 replasman tedavisi ile oral B12 replasman tedavisinin kan B12 vitamini düzeyleri üzerine olan etkisinin karşılaştırılmasıdır.
Materyal ve Metod: Çalışma Ankara Numune Eğitim Araştırma Hastanesi (EAH) Bilimsel Araştırmalar Değerlendirme Komisyonunun 24/07/2013 tarih ve 2013-646 sayılı kararı ile yapılmıştır. Ankara Numune EAH 3 Dahiliye polikliniğine Mayıs–Ekim 2012 tarihleri arasında başvuran ve yeni tanı B12 vitamini eksikliği saptanan, oral veya intramüsküler tedavi başlanan, bir ay sonra kontrole gelen hastalar retrospektif taranarak çalışmaya alınmıştır. İstatistiksel analizler “SPSS for Windows 20,0” paket programı ile yapılmıştır.
Bulgular: Oral vitamin B12 replasman tedavisi alan 56, intramüsküler vitamin B12 replasman tedavisi alan 46 hasta bulundu. Başlangıç değerlerine göre tüm hastalarda anlamlı B12 vitamini düzey artışı olduğu görüldü. (220,73±243,47 pikogram/mililitre (pg/ml), p<0,001). Oral tedavi alanlarda B12 vitamini artışı 252,91±297,23 pg/ml, intramüsküler tedavi alanlarda B12 vitamini artışı 182,96±152,90 pg/ml olarak saptandı. Oral ve intramüsküler tedavi alan hastaların B12 vitamini düzey artışları arasında fark tespit edilmedi (p>0,05).
Sonuç: Oral ve intramüsküler B12 replasman tedavi kollarına ayrılarak yapılan bir çalışmada 90 günlük tedavi sonrasında oral ve intramüsküler tedavi ile B12 vitamini düzeyinde artış olduğu bulunmuş ancak gruplar etkinlik açısından karşılaştırılmamıştır. Bizim çalışmamızda B12 vitamini eksikliği saptanan hastalarda oral ve intramüsküler B12 replasman tedavileri arasında fark saptanmamış olması, oral replasman tedavisinin intramüsküler tedaviye alternatif olabileceğini akla getirmektedir. Konu ile ilgili yeni, daha geniş kapsamlı randomize kontrollü çalışmalara ihtiyaç olduğu ortadadır.

Anahtar Kelimeler

• Oral,İntramüsküler,Vitamin B12,replasman

Kaynakça

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