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老年患者的贫血,特别关注叶酸状态。

Anemia in the elderly patients with special reference to folic acid status.

作者信息

Taguchi H, Sanada H

出版信息

Acta Med Okayama. 1977 Aug;31(4):263-9.

PMID:145163
Abstract

To investigate the role of folic acid deficiency in the pathogenesis of anemia in the elderly, hematological examinationa and assays of serum iron, vitamin B12 and folate were carried out on the 86 elderly patients admitted to a home for the aged. Means of red blood cell counts, hemoglobin levels and hematocrit were 385.3 x 10(4)/mm3, 12g/dl and 36%, respectively. These levels were lower than any other report in Japan. Anemia was detected in 23 out of 86 patients. Judging from mean corposcular volume and mean corposcular hemoglobin, most of them were normocytic and normochromic. Although low serum levels of iron and folate were rather frequently observed, the results on hematological examinations suggest that deficiency of these factors alone is not the cause of the anemia in the elderly patients. Rapid clearance of 5-methyl-tetrahydrofolic acid and increased excretion of formiminoglutamic acid after histidine loading were revealed in some of those who had subnormal serum folate levels. Therefore, supplementation of folic acid is recommended to those who had poor dietary intake.

摘要

为研究叶酸缺乏在老年人贫血发病机制中的作用,对入住养老院的86例老年患者进行了血液学检查以及血清铁、维生素B12和叶酸检测。红细胞计数、血红蛋白水平和血细胞比容的平均值分别为385.3×10⁴/mm³、12g/dl和36%。这些水平低于日本的任何其他报告。86例患者中有23例检测出贫血。从平均红细胞体积和平均红细胞血红蛋白来看,大多数为正细胞正色素性贫血。虽然血清铁和叶酸水平较低的情况较为常见,但血液学检查结果表明,仅这些因素缺乏并非老年患者贫血的原因。部分血清叶酸水平低于正常的患者显示出5-甲基四氢叶酸的快速清除以及组氨酸负荷后亚胺甲基谷氨酸排泄增加。因此,建议饮食摄入不佳的患者补充叶酸。

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