Miller A, Slingerland D W, Cardarelli J, Burrows B A
Nuclear Medicine Services, VA Medical Center, Boston, MA 02130.
Am J Hematol. 1989 Jul;31(3):194-8. doi: 10.1002/ajh.2830310309.
The reported incidence of low serum vitamin B12 levels in patients ranges from 4% to 8%. In only a small percentage can this be ascribed to readily diagnosed pernicious anemia, malabsorption syndrome, or to gastrointestinal surgery. This leaves a number of patients in whom the meaning of the low serum B12 is not immediately apparent. In 71 patients with intact gastrointestinal tracts, hematological indices did not adequately separate patients with decreased absorption of unbound B12 from those with normal absorption. A low absorption of B12, either unbound or food-bound, was found, however, when the level of serum gastrin was elevated. In contrast, a normal absorption of unbound B12 was likely (95% of 44 patients) when the serum gastrin was normal.
据报道，患者血清维生素B12水平低的发生率在4%至8%之间。只有一小部分病例可归因于易于诊断的恶性贫血、吸收不良综合征或胃肠道手术。这就导致了许多患者血清B12水平低的原因并不立即明了。在71例胃肠道完整的患者中，血液学指标无法充分区分未结合型B12吸收减少的患者和吸收正常的患者。然而，当血清胃泌素水平升高时，发现未结合型或食物结合型B12的吸收均降低。相比之下，当血清胃泌素正常时，未结合型B12的吸收可能正常（44例患者中的95%）。
