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维生素B12缺乏的扁平苔藓患者中的贫血、造血物质缺乏、高同型半胱氨酸血症及血清胃壁细胞抗体阳性

Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in oral lichen planus patients with vitamin B12 deficiency.

作者信息

Wu Yu-Hsueh, Yu-Fong Chang Julia, Lee Yi-Pang, Wang Yi-Ping, Sun Andy, Chiang Chun-Pin

机构信息

Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan.

出版信息

J Dent Sci. 2025 Apr;20(2):1102-1109. doi: 10.1016/j.jds.2025.01.007. Epub 2025 Jan 18.

Abstract

BACKGROUND/PURPOSE: Our previous study found that 60 of 588 oral lichen planus (OLP) patients have vitamin B12 deficiency. This study assessed whether the vitamin B12-deficient OLP (B12D/OLP) patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects and evaluated whether all B12D/OLP patients had pernicious anemia (PA).

MATERIALS AND METHODS

The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 60 B12D/OLP patients and 588 healthy control subjects were measured and compared.

RESULTS

We found that 60 B12D/OLP patients had significantly lower mean blood Hb and serum iron, vitamin B12, and folic acid levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than 588 healthy control subjects (all -values <0.01). Moreover, 60 B12D/OLP patients had significantly higher frequencies of macrocytosis (55.0 %), blood Hb (68.3 %) and serum iron (31.7 %) and vitamin B12 (100.0 %) deficiencies, hyperhomocysteinemia (91.7 %), and serum GPCA positivity (66.7 %) than 588 healthy control subjects (all -values <0.001). The four most common types of anemia in 41 anemic B12D/OLP patients were PA (17 patients, 41.5 %), normocytic anemia (12 patients, 29.3 %), iron deficiency anemia (6 patients, 14.6 %), and macrocytic anemia other than PA (5 patients, 12.2 %).

CONCLUSION

The B12D/OLP patients have significantly higher frequencies of macrocytosis, blood Hb and serum iron and vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Only 17 (28.3 %) of 60 B12D/OLP patients have PA.

摘要

背景/目的:我们之前的研究发现,588例口腔扁平苔藓(OLP)患者中有60例存在维生素B12缺乏。本研究评估维生素B12缺乏的OLP(B12D/OLP)患者的贫血、造血物质缺乏、高同型半胱氨酸血症及血清胃壁细胞抗体(GPCA)阳性率是否显著高于健康对照者,并评估所有B12D/OLP患者是否患有恶性贫血(PA)。

材料与方法

检测并比较60例B12D/OLP患者和588例健康对照者的血红蛋白(Hb)、血清铁、维生素B12、叶酸、同型半胱氨酸及GPCA水平。

结果

我们发现,60例B12D/OLP患者的平均血液Hb、血清铁、维生素B12和叶酸水平显著低于588例健康对照者,而平均红细胞体积(MCV)和平均血清同型半胱氨酸水平显著高于健康对照者(所有P值<0.01)。此外,60例B12D/OLP患者的大细胞性贫血(55.0%)、血液Hb(68.3%)、血清铁(31.7%)和维生素B12(100.0%)缺乏、高同型半胱氨酸血症(91.7%)及血清GPCA阳性率(66.7%)显著高于588例健康对照者(所有P值<0.001)。41例贫血的B12D/OLP患者中,四种最常见的贫血类型为PA(17例,41.5%)、正细胞性贫血(12例,29.3%)、缺铁性贫血(6例,14.6%)和非PA的大细胞性贫血(5例,12.2%)。

结论

B12D/OLP患者的大细胞性贫血、血液Hb及血清铁和维生素B12缺乏、高同型半胱氨酸血症及血清GPCA阳性率显著高于健康对照者。60例B12D/OLP患者中仅17例(28.3%)患有PA。

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