Popova D, Daskalov M, Kostadinova I
Vutr Boles. 1988;27(2):123-6.
37 patients with partial stomach resection because of peptic ulcer, performed 5 to 28 years before, were studied. In 29 patients the serum vitamin B12 and folic acid levels were determined by radioimmunoassay. In 19 patients several hematologic indices--hemoglobin, serum iron, erythrocyte morphology, proteinogram--were determined, too. The mean serum vit. B12 level was significantly lower than that of the control group of healthy persons. In 1/3 of these patients the low serum vit. B12 level was accompanied by manifested neurologic complications-myelopathy and polyneuropathy. The mean folic acid level was also low but statistically insignificantly and in patients the value was subnormal. In half of the patients a low degree hypochromic anemia was found. The role of vit. B12 deficiency in the pathogenesis of the neurologic manifestations is discussed and the determination of vit. B12 and folic acid levels is recommended in patients who had undergone gastric resection, especially after 5 years following the resection.
对37例因消化性溃疡行胃部分切除术的患者进行了研究，手术时间在5至28年前。对其中29例患者采用放射免疫分析法测定了血清维生素B12和叶酸水平。对19例患者还测定了多项血液学指标——血红蛋白、血清铁、红细胞形态、蛋白电泳图谱。患者血清维生素B12的平均水平显著低于健康对照组。这些患者中有三分之一血清维生素B12水平低，并伴有明显的神经并发症——脊髓病和多发性神经病。叶酸平均水平也低，但无统计学意义，且患者的值低于正常范围。一半的患者存在轻度低色素性贫血。讨论了维生素B12缺乏在神经表现发病机制中的作用，并建议对胃切除术后的患者，尤其是术后5年以上的患者，测定维生素B12和叶酸水平。
