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贫血与亚急性联合变性患者临床严重程度的相关性。

Correlation between anemia and clinical severity in subacute combined degeneration patients.

机构信息

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

J Clin Neurosci. 2020 Oct;80:11-15. doi: 10.1016/j.jocn.2020.08.005. Epub 2020 Aug 17.

Abstract

OBJECTIVES

Subacute combined degeneration (SCD) is a demyelinating disease commonly caused by vitamin B12 deficiency. Several studies have been reported SCD could be accompanied by anemia. However, the correlation between anemia and clinical severity of SCD patients is unclear. In this study, we aim to analyze the clinical characteristics of SCD concomitant with anemia, and investigate the effect of anemia in predicting the severity of SCD.

METHODS

A total 42 patients were included in the study. Clinical, laboratory, radiological findings, and outcomes from the patients were analyzed. All patients were treated with vitamin B12 for no less than 6 months and a functional disability rating scale was used to evaluate severity of neurological impairment at the time of admission and 3 and 6 months after admission in our study.

RESULTS

85.7% patients had macrocytosis. Decreased serum vitamin B12 levels were found in 27 patients (64.3%). MRI showed long-segment abnormality on the spinal cord in 22 patients. No differences in rating score were found in patients grouped by sex, age, clinical course, serum vitamin B12, or MRI manifestations at the time of admission or at the follow-up visits. Negative correlation was seen between hemoglobin levels and the clinical severity scores on admission.

CONCLUSION

Not all patients with SCD concomitant with anemia had decreased serum vitamin B12 level. The inverse correlation between hemoglobin level and clinical severity suggests the degree of anemia can help in evaluating the extent of neurologic impairment.

摘要

目的

亚急性联合变性(SCD)是一种常见的脱髓鞘疾病,通常由维生素 B12 缺乏引起。有几项研究报道 SCD 可伴有贫血。然而,贫血与 SCD 患者临床严重程度之间的相关性尚不清楚。在本研究中,我们旨在分析伴有贫血的 SCD 的临床特征,并探讨贫血对预测 SCD 严重程度的影响。

方法

共纳入 42 例患者。分析了患者的临床、实验室、影像学表现和结局。所有患者均接受维生素 B12 治疗不少于 6 个月,本研究采用神经功能障碍评分量表在入院时和入院后 3 个月和 6 个月评估神经损伤严重程度。

结果

85.7%的患者有巨细胞性贫血。27 例(64.3%)患者血清维生素 B12 水平降低。22 例患者 MRI 显示脊髓长节段异常。按性别、年龄、临床病程、血清维生素 B12 或 MRI 表现分组,入院时或随访时评分无差异。入院时血红蛋白水平与临床严重程度评分呈负相关。

结论

并非所有伴有贫血的 SCD 患者均有血清维生素 B12 水平降低。血红蛋白水平与临床严重程度呈负相关,提示贫血程度有助于评估神经损伤程度。

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