200例MA患者叶酸与VitB12缺乏分布特点及相关性分析

发布时间：2018-11-10 11:20

【摘要】：目的:回顾分析我院2005年12月—2013年12月住院确诊的巨幼细胞性贫血患者临床常见检测指标及其叶酸/Vit B12缺乏情况,进一步了解该疾病的特点。方法:(1)确定研究病例的纳入与排除标准及搜集病例的时间范围。(2)通过计算机病案管理系统及病案室搜集确定年限的符合纳入标准的相关病例。(3)根据病例信息采集所需的基本信息和数据。(4)根据数据进行统计分析、得出结论。结果:1.根据统计分析,不同年龄组性别构成有差异,不同性别整体之间没有差异。2.在发病原因中,慢性胃炎和饮食差者共159例,占79.5%,占整体患者的绝大多数。3.在200例MA患者中,混合性贫血者共12例,占全部的6%。4.MA患者中、重度贫血共有176例,占88%。在叶酸与Vit B12的检测中,至少有一项减少者共有168例,占了84%,其中有单一叶酸缺乏者34例,占17%,单一Vit B12缺乏者107例,占53.5%。根据统计分析叶酸与Vit B12的缺乏程度在各种贫血的程度中无差异。5.200例患者中,红细胞、白细胞、血小板均正常者只有2例,但这2例患者的血红蛋白均较正常值低。其中红细胞异常最为常见,表现为计数减低,共有194例,占97%。根据统计分析说明叶酸与Vit B12的缺乏对红细胞、白细胞及血小板的影响差异有统计学意义。6.在外周血直接及间接胆红素的测定中,至少有一项异常者共144例,共占72%。7.167例MA患者中122例糖类抗原15-3呈阳性,占73.1%。根据统计分析得出:①叶酸与CA15-3检查结果相关,叶酸不缺乏时CA15-3阳性的可能性越大;②维生素B12与CA15-3检查结果相关,维生素B12缺乏时CA15-3阳性的可能性越大。结论:1.200例MA患者维生素B12缺乏占多数。叶酸与Vit B12的缺乏程度对于贫血的严重程度无影响。2.巨幼贫病人中叶酸与Vit B12的缺乏对红细胞、白细胞及血小板均有影响,对红细胞影响最大。MA贫血以中重度为主。3.CA15-3与叶酸、Vit B12均相关。
[Abstract]:Objective: to study the clinical features of megaloblastic anemia (MPA) diagnosed in our hospital from December 2005 to December 2013 and its deficiency of folic acid / Vit B12. Methods: (1) to determine the inclusion and exclusion criteria of the study cases and the time range of collecting cases. (2) to determine the relevant cases according to the inclusion criteria through the computer medical record management system and the medical record room. The basic information and data needed for the collection of case information. (4) Statistical analysis based on data, come to conclusion The result is 1: 1. According to the statistical analysis, the gender composition of different age groups is different, and there is no difference between different gender groups. 2. 2. Among the causes, 159 cases (79. 5%) were chronic gastritis and poor diet, accounting for 3. 3% of the total number of patients. Of the 200 patients with MA, there were 12 cases of mixed anemia, accounting for the total number of 6%.4.MA patients, 176 cases of severe anemia, accounting for 88%. In the detection of folic acid and Vit B12, there were at least one item of decrease in 168 cases, accounting for 84 cases, of which 34 cases were single folic acid deficiency (17 cases) and 107 cases were single Vit B12 deficiency (53.5%). According to statistical analysis, there was no difference in the degree of folic acid deficiency and Vit B12 deficiency in all kinds of anemia. In 5.200 patients, only 2 patients had normal erythrocytes, white blood cells and platelets, but the hemoglobin levels of these two patients were lower than those of normal patients. The most common abnormality of erythrocyte was the decrease of count, 194 cases (97. 7%). According to statistical analysis, the effect of folic acid and Vit B12 deficiency on erythrocyte, leukocyte and platelets was significantly different. In the determination of direct and indirect bilirubin in peripheral blood, there was at least one abnormality in 144 cases, accounting for 72% of 7.167 cases of MA. 122 cases (73.1%) were positive for carbohydrate antigen 15-3. According to the statistical analysis, the results of folic acid and CA15-3 were related, the possibility of positive CA15-3 was higher when folic acid was not deficient, and the possibility of CA15-3 positive with vitamin B12 was higher when vitamin B12 was deficient. Conclusion: vitamin B 12 deficiency accounts for the majority in 1.200 patients with MA. The deficiency of folic acid and Vit B12 had no effect on the severity of anemia. The deficiency of folic acid and Vit B12 affected erythrocytes, white blood cells and platelets, but had the greatest effect on erythrocytes in megaloblastic patients. MA anemia was mainly moderate and severe. 3.CA15-3 was correlated with folic acid and Vit B12.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R556

【参考文献】