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[一名患有恶性贫血的中国患者;来自印度尼西亚时期的医学经历]

[A Chinese patient with pernicious anemia; a medical experience from the Indonesian period].

作者信息

Zuidema P J

机构信息

Tropische Geneeskunde, Amsterdam.

出版信息

Ned Tijdschr Geneeskd. 1996 Mar 9;140(10):561-3.

PMID:8628409
Abstract

On May 19th 1952 a 64-year-old Chinese man was admitted to a hospital at Yogyakarta (Indonesia) on account of a sawing noise in both ears and some soreness of the tongue. He had macrocytic anemia (haemoglobin: 3.7 mmol/l) and the tongue showed some smooth patches. A presumptive diagnosis of pernicious anaemia was confirmed by gastric analysis which revealed a histamine fast achlorhydria. On treatment with vitamin B12 the noise in the ears rapidly disappeared and there was a characteristic rise in reticulocytes and haemoglobin content. After 3 years the patient died of inoperable gastric carcinoma. There probably was a hereditary component as in a 54-year-old cousin, who also suffered (and died) from gastric carcinoma, gastric analysis showed a histamine fast achlorhydria. The patient is the first case of pernicious anaemia described in a Chinese resident of Indonesia. A survey of the literature revealed that until now pernicious anaemia has been recorded in 31 Chinese patients, in chronological order from the following countries: U.S (1945), Indonesia (1954), Singapore (1967), Hong-Kong (1969) and China (1990). In the autochthonous Chinese population no case has yet been reported.

摘要

1952年5月19日,一名64岁的中国男子因双耳出现锯木声和舌头有些疼痛而住进印度尼西亚日惹的一家医院。他患有大细胞性贫血(血红蛋白:3.7毫摩尔/升),舌头有一些光滑的斑块。通过胃分析确诊为恶性贫血,结果显示组胺无反应性胃酸缺乏。用维生素B12治疗后,耳内的声音迅速消失,网织红细胞和血红蛋白含量有特征性升高。3年后,患者死于无法手术的胃癌。可能存在遗传因素,因为一名54岁的表弟也患有(并死于)胃癌,胃分析显示组胺无反应性胃酸缺乏。该患者是印度尼西亚华裔居民中描述的第一例恶性贫血病例。对文献的调查显示,到目前为止,已有31例中国患者被记录患有恶性贫血,按时间顺序来自以下国家:美国(1945年)、印度尼西亚(1954年)、新加坡(1967年)、香港(1969年)和中国(1990年)。在本土中国人群中尚未有病例报告。

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