Department of Dentistry, MacKay Memorial Hospital, Taipei, Taiwan; School of Dentistry and Graduate Institute of Dental Sciences, China Medical University, Taichung, Taiwan; School of Dentistry, Taipei Medical University, Taipei, Taiwan; School of Dentistry, 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.
J Formos Med Assoc. 2017 Aug;116(8):613-619. doi: 10.1016/j.jfma.2017.02.001. Epub 2017 Mar 15.
BACKGROUND/PURPOSE: Microcytosis is defined as mean corpuscular volume (MCV) < 80 fL. This study assessed the anemia statuses and hematinic deficiencies in 30 patients with gastric parietal cell antibody-positive microcytosis (GPCA+/microcytosis) and 210 patients with GPCA-negative microcytosis (GPCA-/microcytosis).
We measured and compared the mean red blood cell (RBC) count, MCV, and RBC distribution width (RDW), as well as blood levels of hemoglobin, iron, vitamin B12, folic acid, and homocysteine among the aforementioned patient groups and 240 healthy controls.
Compared with GPCA-/microcytosis, the positive counterparts presented with a lower mean serum vitamin B12 level (marginal significance), significantly higher mean RDW and serum homocysteine level, and significantly greater frequencies of vitamin B12 deficiency and high homocysteine level. GPCA-/microcytosis patients had significantly greater frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of RBC count > 5 × 10/L than healthy controls. Moreover, 19 of 30 GPCA+/microcytosis patients and 143 of 210 GPCA-/microcytosis patients had anemia, with iron deficiency anemia being the most common type, followed by thalassemia trait-induced anemia and microcytic anemia due to other causes.
We conclude that GPCA in microcytosis patients' sera may have caused significantly lower mean vitamin B12 level as well as significantly higher mean RDW and serum homocysteine level in our GPCA+/microcytosis patients than in GPCA-/microcytosis patients. Herein, iron deficiency anemia was the most common type of anemia in anemic GPCA+/microcytosis and GPCA-/microcytosis patients.
背景/目的：小细胞性贫血的定义为平均红细胞体积（MCV）<80fl。本研究评估了 30 例壁细胞抗体阳性小细胞性贫血（GPCA+/小细胞性贫血）患者和 210 例 GPCA 阴性小细胞性贫血（GPCA-/小细胞性贫血）患者的贫血状态和血液缺乏情况。
我们测量并比较了上述患者组和 240 名健康对照者的平均红细胞计数（RBC）、MCV 和红细胞分布宽度（RDW）以及血红蛋白、铁、维生素 B12、叶酸和同型半胱氨酸的血液水平。
与 GPCA-/小细胞性贫血相比，阳性患者的血清维生素 B12 水平较低（边缘显著性），RDW 和血清同型半胱氨酸水平显著较高，维生素 B12 缺乏和高同型半胱氨酸血症的发生率显著较高。GPCA-/小细胞性贫血患者的血红蛋白、铁、维生素 B12 和叶酸缺乏以及 RBC 计数>5×10/L 的发生率明显高于健康对照组。此外，30 例 GPCA+/小细胞性贫血患者中有 19 例和 210 例 GPCA-/小细胞性贫血患者中有 143 例患有贫血，其中缺铁性贫血最为常见，其次是地中海贫血所致小细胞性贫血和其他原因所致小细胞性贫血。
我们的结论是，GPCA 可能导致了小细胞性贫血患者血清中的 MCV 显著降低，RDW 和血清同型半胱氨酸水平显著升高，这与我们的 GPCA+/小细胞性贫血患者和 GPCA-/小细胞性贫血患者相比。在此，缺铁性贫血是贫血 GPCA+/小细胞性贫血和 GPCA-/小细胞性贫血患者中最常见的贫血类型。
