萎缩性舌炎与贫血相关因子的关系附20份临床病例汇报

发布时间：2018-12-17 18:42

【摘要】：目的:萎缩性舌炎为口腔黏膜常见疾病之一,病因复杂。本研究通过收集临床病例资料,分析相关数据,探索萎缩性舌炎与贫血相关因子(血常规、血清维生素B12、血清铁蛋白、叶酸)的关系,以指导临床诊断与治疗。方法:收集2015年4月至2016年12月于青岛大学附属医院口腔黏膜科主治及以上医师诊断为萎缩性舌炎的临床病例共33例。排除舌部念珠菌镜检阳性患者,近期服用维生素、抗生素或含铁药物患者,干燥综合征患者及舌背黏膜出现萎缩性改变的其他疾病(如地图舌、口腔扁平苔藓、正中菱形舌、放射性口炎等)的患者。检测萎缩性舌炎患者的血常规、血清维生素B12、血清铁蛋白及叶酸水平。对数据进行统计分析,采用百分率来表示各数据之间的大小关系。探索萎缩性舌炎与贫血相关因子的关系。结果:33例萎缩性舌炎患者中,男女比例为1:4.5,最低年龄32岁,最高年龄80岁,平均年龄57.9岁,50-60岁有12人,60-70岁有10人,共计22人,占66.67%;33例萎缩性舌炎患者中,血红蛋白、红细胞计数、红细胞比容指标出现异常者共计19人,占57.58%;33例萎缩性舌炎患者中,维生素B12缺乏16人次,占48.5%,血清铁蛋白缺乏10人次,占30.3%,其中维生素B12、血清铁蛋白均缺乏4例,占12.12%;33例萎缩性舌炎患者叶酸水平均正常;7例大细胞性贫血患者均有维生素B12缺乏,4例小细胞低色素性贫血患者均有血清铁蛋白缺乏;14例血常规正常的萎缩性舌炎患者中,有5例出现维生素B12或血清铁蛋白降低。结论:排除感染因素及其他因素,萎缩性舌炎好发于中老年女性,其发生与贫血相关因子有关;在异常的贫血相关因子中,血清维生素B12缺乏比例占第一位,其次为血清铁蛋白缺乏;本研究未发现萎缩性舌炎的发生与叶酸缺乏有关;维生素B12缺乏或血清铁蛋白缺乏引起的舌乳头萎缩可能会早于血常规指标的改变。
[Abstract]:Objective: atrophic glossitis is one of the common diseases of oral mucosa. In order to guide clinical diagnosis and treatment, this study investigated the relationship between atrophic glossitis and anemia related factors (blood routine, serum vitamin B12, serum ferritin, folic acid) by collecting clinical data and analyzing relevant data. Methods: from April 2015 to December 2016, 33 patients with atrophic glossitis diagnosed by oral mucosal department or above in the affiliated Hospital of Qingdao University were collected. Other diseases such as map tongue, oral lichen planus, median rhomboid tongue, and other diseases (map tongue, oral lichen planus, median rhomboid tongue), patients with Sjogren's syndrome and atrophic changes in the dorsal mucosa of the tongue are excluded. A patient with radiation stomatitis, etc. The blood routine, serum vitamin B 12, serum ferritin and folic acid levels were measured in patients with atrophic glossitis. Statistical analysis of the data, the use of percentages to represent the size of the relationship between the data. To explore the relationship between atrophic glossitis and anemia related factors. Results: among 33 patients with atrophic glossitis, the ratio of male to female was 1: 4.5, the minimum age was 32 years old, the highest age was 80 years old, the average age was 57.9 years old, there were 12 patients aged 50-60 years and 10 patients aged 60-70 years. In 33 patients with atrophic glossitis, 19 patients (57.58) had abnormal hemoglobin, erythrocyte count and erythrocyte specific volume index. In 33 patients with atrophic glossitis, there were 16 cases of vitamin B12 deficiency (48.5%), 10 cases of serum ferritin deficiency (30.3%), and 4 cases of vitamin B12 and serum ferritin deficiency (12.12%). The levels of folic acid were normal in 33 patients with atrophic glossitis, vitamin B12 deficiency was found in 7 patients with macrocytic anemia and serum ferritin deficiency in 4 patients with small cell hypochromic anemia. Of 14 patients with atrophic glossitis with normal blood routine, 5 had vitamin B 12 or decreased serum ferritin. Conclusion: the incidence of atrophic glossitis in middle-aged and elderly women is related to anemia related factors, excluding infection factors and other factors. Among the abnormal anemia related factors, the proportion of serum vitamin B12 deficiency was the first, followed by the serum ferritin deficiency, and there was no relationship between the occurrence of atrophic glossitis and folic acid deficiency in this study. Tongue papilla atrophy caused by vitamin B 12 deficiency or serum ferritin deficiency may be earlier than the change of blood routine.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R556;R781.57

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