患有大细胞性贫血的口腔黏膜疾病患者的造血物质缺乏与恶性贫血
Hematinic deficiencies and pernicious anemia in oral mucosal disease patients with macrocytosis.
作者信息
Chang Julia Yu-Fong, Wang Yi-Ping, Wu Yang-Che, Cheng Shih-Jung, Chen Hsin-Ming, Sun Andy
机构信息
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
出版信息
J Formos Med Assoc. 2015 Aug;114(8):736-41. doi: 10.1016/j.jfma.2015.03.015. Epub 2015 Apr 29.
BACKGROUND/PURPOSE: Macrocytosis is defined as having the mean corpuscular volume (MCV) ≥ 100 fL. This study assessed hematinic deficiencies and pernicious anemia (PA) in oral mucosal disease patients with macrocytosis.
METHODS
The blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine concentrations and MCV in 60 oral mucosal disease patients with macrocytosis were measured and compared with the corresponding data in 120 age- and sex-matched healthy control participants. PA was defined by the World Health Organization (WHO) as having an Hb concentration < 13 g/dL for men and < 12 g/dL for women, an MCV ≥ 100 fL, a serum vitamin B12 level < 200 pg/mL, and serum gastric parietal cell antibody (GPCA) positivity.
RESULTS
We found that 30 (50.0%), 7 (11.7%), 24 (40.0%), and three (5.0%) oral mucosal disease patients with macrocytosis had deficiencies of Hb (men < 13 g/dL, women < 12 g/dL), iron (< 60 μg/dL), vitamin B12 (< 200 pg/mL), and folic acid (< 4 mg/mL), respectively. Moreover, 38 (63.3%) and 16 (26.7%) macrocytosis patients had abnormally high blood homocysteine level (> 12.3 μM) and serum GPCA positivity, respectively. Macrocytosis patients had a significantly higher frequency of Hb, iron, or vitamin B12 deficiency, of abnormally elevated blood homocysteine level, and of GPCA positivity than healthy control participants (p < 0.001). However, only 16.7% of 60 macrocytosis patients were diagnosed as having PA by the WHO definition.
CONCLUSION
Only 16.7% of oral mucosal disease patients with macrocytosis are discovered to have PA by the WHO definition.
背景/目的：大细胞性贫血定义为平均红细胞体积（MCV）≥100 fL。本研究评估了大细胞性贫血的口腔黏膜疾病患者的造血物质缺乏情况及恶性贫血（PA）。
方法
测定60例大细胞性贫血的口腔黏膜疾病患者的血红蛋白（Hb）、铁、维生素B12、叶酸和同型半胱氨酸浓度以及MCV，并与120例年龄和性别匹配的健康对照者的相应数据进行比较。世界卫生组织（WHO）将PA定义为男性Hb浓度<13 g/dL、女性Hb浓度<12 g/dL、MCV≥100 fL、血清维生素B12水平<200 pg/mL且血清胃壁细胞抗体（GPCA）呈阳性。
结果
我们发现，60例大细胞性贫血的口腔黏膜疾病患者中，分别有30例（50.0%）、7例（11.7%）、24例（40.0%）和3例（5.0%）存在Hb（男性<13 g/dL，女性<12 g/dL）、铁（<60 μg/dL）、维生素B12（<200 pg/mL）和叶酸（<4 mg/mL）缺乏。此外，38例（63.3%）和16例（26.7%）大细胞性贫血患者的血液同型半胱氨酸水平异常升高（>12.3 μM）和血清GPCA呈阳性。与健康对照者相比，大细胞性贫血患者的Hb、铁或维生素B12缺乏、血液同型半胱氨酸水平异常升高以及GPCA阳性的发生率显著更高（p<0.001）。然而，按照WHO的定义，60例大细胞性贫血患者中只有16.7%被诊断为PA。
结论
按照WHO的定义，大细胞性贫血的口腔黏膜疾病患者中只有16.7%被发现患有PA。
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