Chang Julia Yu-Fong, Wang Yi-Ping, Wu Yang-Che, Cheng Shih-Jung, Chen Hsin-Ming, Sun Andy
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.
J Formos Med Assoc. 2015 Sep;114(9):806-12. doi: 10.1016/j.jfma.2015.06.006. Epub 2015 Jul 15.
BACKGROUND/PURPOSE: Folic acid deficiency (FAD) may result in macrocytic anemia. This study assessed the hematinic deficiencies and anemia statuses in oral mucosal disease patients with FAD (defined as folic acid ≤ 6 ng/mL).
The blood hemoglobin (Hb), iron, vitamin B12, and folic acid concentrations, serum gastric parietal cell antibody level, and mean corpuscular volume (MCV) in 198 oral mucosal disease patients with FAD were measured. Based on World Health Organization (WHO) criteria, anemia or Hb deficiency was defined as having an Hb concentration of <13 g/dL for men and <12 g/dL for women. In this study, macrocytic anemia due to FAD was defined as having an MCV ≥100 fL and folic acid ≤6 ng/mL; pernicious anemia as having MCV ≥100 fL, vitamin B12 < 200 pg/mL, and serum gastric parietal cell antibody positivity; iron deficiency anemia as having MCV <80 fL and iron <60 μg/dL; and thalassemia trait as having MCV <74 fL, red blood cell (RBC) count > 5.0 × 10(12)/L, and Mentzer index (MCV/RBC) < 13.
We found that by WHO definitions, 73 (36.9%), 41 (20.7%), and 10 (5.1%) of our 198 FAD patients had concomitant Hb, iron, and vitamin B12 deficiencies, respectively. Of 73 anemic FAD patients, three had macrocytic anemia due to FAD, one had pernicious anemia, 14 had iron deficiency anemia, eight had thalassemia trait, and the resting 47 had normocytic anemia.
In addition to macrocytic anemia (2.0%), FAD patients may have concomitant normocytic (23.7%) or microcytic (11.1%) anemia.
背景/目的：叶酸缺乏（FAD）可能导致巨幼细胞贫血。本研究评估了患有FAD（定义为叶酸≤6 ng/mL）的口腔黏膜病患者的造血物质缺乏和贫血状况。
测定了198例患有FAD的口腔黏膜病患者的血红蛋白（Hb）、铁、维生素B12和叶酸浓度、血清胃壁细胞抗体水平及平均红细胞体积（MCV）。根据世界卫生组织（WHO）标准，贫血或Hb缺乏定义为男性Hb浓度<13 g/dL，女性Hb浓度<12 g/dL。在本研究中，因FAD导致的巨幼细胞贫血定义为MCV≥100 fL且叶酸≤6 ng/mL；恶性贫血定义为MCV≥100 fL、维生素B12<200 pg/mL且血清胃壁细胞抗体阳性；缺铁性贫血定义为MCV<80 fL且铁<60 μg/dL；地中海贫血特征定义为MCV<74 fL、红细胞（RBC）计数>5.0×10(12)/L且Mentzer指数（MCV/RBC）<13。
我们发现，根据WHO的定义，在我们的198例FAD患者中，分别有73例（36.9%）、41例（20.7%）和10例（5.1%）同时存在Hb、铁和维生素B12缺乏。在73例贫血的FAD患者中，3例因FAD导致巨幼细胞贫血，1例患有恶性贫血，14例患有缺铁性贫血，8例具有地中海贫血特征，其余47例患有正细胞性贫血。
除了巨幼细胞贫血（2.0%）外，FAD患者可能同时存在正细胞性贫血（23.7%）或小细胞性贫血（11.1%）。
Zotero 插件