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目的探讨有神经精神症状的巨幼细胞性贫血(MA)患者的临床特点。方法回顾性分析16例合并神经精神症状表现的巨幼细胞性贫血患者的临床资料,分析贫血程度与神经精神症状的关系。结果 16例巨幼细胞性贫血中,单纯叶酸缺乏3例,单纯维生素B12缺乏4例,叶酸及维生素B12均缺乏9例。因为叶酸、维生素B12的缺乏可致神经精神损害,但贫血的程度与神经精神的损害无依赖关系,有些神经精神症状重而贫血症状轻或无贫血。结论合并神经精神症状的巨幼细胞性贫血临床上极易误诊,尤其对于首发神经精神症状的病例应考虑到巨幼细胞性贫血的可能,做到早诊断、早治疗,减少致残率。
Objective To investigate the clinical features of megaloblastic anemia (MA) patients with neuropsychiatric symptoms. Methods The clinical data of 16 patients with megaloblastic anemia complicated with neuropsychiatric symptoms were analyzed retrospectively to analyze the relationship between anemia and neuropsychiatric symptoms. Results Among the 16 cases of megaloblastic anemia, 3 cases were deficient in folic acid deficiency, 4 cases were simple vitamin B12 deficiency, 9 cases were deficient in folic acid and vitamin B12. Because of folic acid, vitamin B12 deficiency can cause neuropsychiatric damage, but the degree of anemia and neuropsychiatric damage no dependence, some neuropsychiatric symptoms of heavy and anemia symptoms of light or no anemia. Conclusions Megaloblastic anemia complicated with neuropsychiatric symptoms is extremely misdiagnosed clinically. Especially in the first episode of neuropsychiatric symptoms, the possibility of megaloblastic anemia should be considered and early diagnosis and early treatment should be done to reduce the morbidity.