Blundell E L, Matthews J H, Allen S M, Middleton A M, Morris J E, Wickramasinghe S N
J Clin Pathol. 1985 Oct;38(10):1179-84. doi: 10.1136/jcp.38.10.1179.
To determine the functional importance of the low B12 and red cell folate concentrations repeatedly observed in the elderly 200 consecutive patients admitted to a geriatric unit were studied. Forty six of the patients had low serum concentrations of B12 (15), red cell folate (26), or both (five). Serum B12 and red cell folate concentrations correlated with mean cell volume, and serum B12 correlated with the neutrophil lobe count. Bone marrow deoxyuridine suppression was abnormal in 35% of the patients with low vitamin concentrations, but 55% of those with abnormal deoxyuridine suppression had morphologically normal bone marrow, and 73% had a normal mean cell volume. In patients with low vitamin values the deoxyuridine suppressed value correlated with the haemoglobin concentration and neutrophil lobe count. Thus synthesis of thymidylate was impaired by vitamin B12 or folate deficiency in at least 8% of newly admitted elderly patients, many of whom had normal blood counts despite the biochemical disturbance affecting haemopoiesis. A nutritionally depleted diet may have been responsible for many of the low vitamin values.
为了确定在老年人中反复观察到的低维生素B12和红细胞叶酸浓度的功能重要性，对连续入住老年病房的200例患者进行了研究。其中46例患者血清维生素B12浓度低（15例）、红细胞叶酸浓度低（26例）或两者均低（5例）。血清维生素B12和红细胞叶酸浓度与平均红细胞体积相关，血清维生素B12与中性粒细胞叶数相关。在维生素浓度低的患者中，35%的患者骨髓脱氧尿苷抑制异常，但在脱氧尿苷抑制异常的患者中，55%的患者骨髓形态正常，73%的患者平均红细胞体积正常。在维生素值低的患者中，脱氧尿苷抑制值与血红蛋白浓度和中性粒细胞叶数相关。因此，在至少8%的新入院老年患者中，维生素B12或叶酸缺乏会损害胸苷酸的合成，尽管影响造血的生化紊乱存在，但其中许多患者的血细胞计数正常。营养缺乏的饮食可能是许多维生素值低的原因。
