目的调查神经科老年住院患者维生素(Vit)B12缺乏的状况。方法对本院神经内科2007年3月—2008年7月间连续住院的、年龄≥60岁的患者进行血清叶酸、VitB12、同型半胱氨酸(Hcy)等指标的检测,筛查VitB12缺乏者。共827例患者入组,平均年龄77.1±7.5岁。所有患者均无严重肝肾功能障碍,且近3个月内未补充VitB12。对VitB12正常患者和缺乏患者的神经系统症状、体征及神经电生理检查结果进行比较和分析。结果VitB12缺乏者有163例(占所有患者总数的19.71%),神经电生理检查多有异常,患病率女性高于男性,并随年龄增长有增加的趋势。VitB12缺乏者中伴有胃肠道疾病的比率较高,巨红细胞贫血仅为9.82%。VitB12缺乏患者更易出现行走不稳及振动觉减退等症状,更多还伴有脑梗死、高血压、冠心病等慢性疾病。结论神经科住院老年患者常伴有VitB12缺乏症,症状表现多样,神经系统表现较之巨红细胞贫血更常见。 Objective To investigate the condition of vitamin B12 deficiency in neurological inpatients. Methods Serum folic acid, VitB12, homocysteine ​​(Hcy) and other indicators of hospitalized patients aged ≥60 years who were hospitalized consecutively from March 2007 to July 2008 in our hospital were detected. The patients with VitB12 deficiency . A total of 827 patients were enrolled, with an average age of 77.1 ± 7.5 years. All patients had no serious liver and kidney dysfunction, and did not replenish VitB12 in the recent 3 months. Neurological symptoms, signs and neuroelectrophysiological findings were compared and analyzed between patients with and without VitB12. Results There were 163 cases of VitB12 deficiency (19.71% of the total), abnormal electrophysiological examination had more abnormalities, the prevalence of women than men, and with the increasing trend of age. VitB12 deficiency associated with higher rates of gastrointestinal diseases, only 9.82% of giant cell anemia. VitB12 lack of patients are more prone to walking and vibration loss and other symptoms, but also more associated with cerebral infarction, hypertension, coronary heart disease and other chronic diseases. Conclusion Geriatric hospitalized elderly patients are often accompanied by VitB12 deficiency, the symptoms of diverse performance of the nervous system is more common than the giant cell anemia.