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目的 :探讨老年人巨幼细胞性贫血的临床特点。方法 :对 2 4例老年人巨幼细胞性贫血住院患者的资料进行分析。结果 :老年人巨幼细胞性贫血男性多见 ,男女比例为 2∶1,伴有心、脑血管等内科其他疾病 2 0例 ,占 83 % ;以非血液病诊断入院的 14例 ,占 5 8 3 % ,外周全血细胞减少 16例 ,占 66 7% ;骨髓有核细胞增生程度均在活跃以上。血清乳酸脱氢酶检测 18例 ,升高 16例。维生素B12 检测 14例 ,减少 10例。检出伴有慢性消化道疾病者 (慢性胃炎、胃溃疡、十二指肠球部溃疡、十二指肠憩室、食道裂孔疝、慢性胆囊炎胆石症 ) 2 1例 ,占 87 5 % ,贲门癌 1例 ,占 4 1%。用叶酸、维生素B12 治疗效果显著。结论 :老年人巨幼细胞性贫血常因非血液病就诊而易于漏诊。临床上应与再生障碍性贫血、骨髓增生异常综合征 (MDS)相鉴别。老年人巨幼细胞性贫血的发生与存在的消化道疾病关系密切 ,进行相关检查可避免遗漏潜在的疾病。
Objective: To investigate the clinical features of megaloblastic anemia in the elderly. Methods: The data of 24 hospitalized patients with megaloblastic anemia were analyzed. Results: Male megaloblastic anemia was more common in older men. The ratio of male to female was 2: 1. There were 20 cases of other medical diseases such as heart and cerebrovascular diseases, accounting for 83%. Among them, 14 cases diagnosed as non-hematological diseases accounted for 58 3%, 16 cases of peripheral pancytopenia, accounting for 66.7%; the degree of bone marrow nucleated cells were more active. Serum lactate dehydrogenase test in 18 cases, an increase of 16 cases. 14 cases of vitamin B12 detection, a decrease of 10 cases. 21 patients with chronic gastrointestinal diseases (chronic gastritis, gastric ulcer, duodenal ulcer, duodenal diverticula, hiatal hernia and chronic cholecystitis) were detected in 21 cases, accounting for 87.5% 1 case of cancer, accounting for 41%. With folic acid, vitamin B12 treatment is remarkable. Conclusion: Megaloblastic anemia in the elderly is often misdiagnosed due to non-hematological disease. Clinic and aplastic anemia, myelodysplastic syndrome (MDS) phase identification. The occurrence of megaloblastic anemia in the elderly is closely related to the existing gastrointestinal diseases, and the related examination can avoid the omission of potential diseases.