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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42例已经确诊为巨幼细胞性贫血的老年患者的临床资料进行回顾性分析。结果老年人巨幼细胞性贫血男性多见,男女比例为2∶1。以非血液病诊断入院24例,占57%;外周全血细胞减少25例,占60%;血清乳酸脱氢酶升高26例;占62%。维生素B12减少者28例;检出伴有慢性消化道疾病者38例,占90%。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 clinical data of 42 elderly patients with confirmed megaloblastic anemia were retrospectively analyzed. Results Megaloblastic anemia in older men more common, male to female ratio of 2: 1. The diagnosis of non-hematological diseases in 24 cases, accounting for 57%; peripheral pancytopenia in 25 cases, accounting for 60%; serum lactate dehydrogenase increased in 26 cases, accounting for 62%. Vitamin B12 decreased in 28 cases; detected with chronic gastrointestinal diseases in 38 cases, accounting for 90%. With folic acid, vitamin B12 treatment is remarkable. Conclusion The elderly megaloblastic anemia is often missed because of 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.