Joosten E, Pelemans W, Hiele M, Goossens W
Universitair Ziekenhuis St. Pieter, Leuven, Belgiäe.
Ned Tijdschr Geneeskd. 1990 Mar 31;134(13):652-6.
In order to determine the relevance of low vitamin B12 concentration in elderly persons (greater than 65 years), serum vitamin B12 levels were measured in 292 consecutive patients upon their admission to a geriatric ward. Eighty (27%) of them were anaemic (haemoglobin less than or equal to 7.14 mmol/l). The vitamin B12 concentration was not statistically different between males and females, nor between the anaemic and non-anaemic groups. Twenty-two patients (7.5%) had a low vitamin B12 level; of these, 10 had a haemoglobin concentration higher than 7.14 mmol/l and a mean corpuscular volume lower than 98 fl. In addition, serum vitamin B12 levels were also measured in 178 consecutive anaemic patients hospitalized in the same ward. Seventeen (9.5%) of them had a vitamin B12 deficiency although in 11 the MCV was lower than 98 fl. Hypersegmented polymorphonuclear leukocytes were rarely observed in the peripheral blood smear. Pernicious anaemia could only be diagnosed in 1 patient. Serum vitamin B12 estimation may be necessary to detect vitamin B12 deficiency but a low level requires additional diagnostic investigation.
为了确定老年患者（年龄大于65岁）维生素B12浓度偏低的相关性，我们对292名连续入住老年病房的患者入院时的血清维生素B12水平进行了测量。其中80人（27%）贫血（血红蛋白小于或等于7.14 mmol/L）。男性和女性之间、贫血组和非贫血组之间的维生素B12浓度无统计学差异。22名患者（7.5%）维生素B12水平偏低；其中，10人血红蛋白浓度高于7.14 mmol/L，平均红细胞体积低于98 fl。此外，我们还对同一病房连续收治的178名贫血患者的血清维生素B12水平进行了测量。其中17人（9.5%）存在维生素B12缺乏，尽管其中11人平均红细胞体积低于98 fl。在外周血涂片上很少观察到多分叶核中性粒细胞。仅1例患者被诊断为恶性贫血。血清维生素B12检测对于发现维生素B12缺乏可能是必要的，但水平偏低需要进一步的诊断性检查。
