摘要
目的调查神经科住院老年患者维生素（Vit）B12缺乏的状况。方法对本院神经内科2007年3月-2008年7月间连续住院的、年龄≥60岁、无严重肝肾功能障碍、且近3个月未补充VitB12的827例患者血清叶酸、VitB12、同型半胱氨酸（Hcy）等指标进行检测，筛查VitB12缺乏者；对VitB12正常者和缺乏者的神经系统症状、体征及实验室检查结果进行比较和分析。结果827例患者中，平均年龄（77．1±7．5）岁，检出VitB12缺乏者163例（19．7％），女性患病率（21．9％）高于男性（17．4％），并随年龄增长有增加的趋势。VitB12缺乏者中伴有胃肠道疾病的比率较高。与VitB12正常者比较，VitB12缺乏者更易出现行走不稳（27．0％）及振动觉减退（34．4％），更多合并脑梗死（62．6％）、高血压（68．7％）、冠心病（39．9％）等慢性疾病。VitB12缺乏者的神经电生理检查多有异常（77％），但巨幼红细胞贫血仅为9．82％。结论神经科住院老年患者VitB12缺乏常见，症状表现多样，神经系统表现较巨幼红细胞贫血更常见。
Objective To investigate the status of vitamin （Vit） B12 deficiency in elderly inpatients in department of neurology. Methods 827 patients admitted to the department of neurology of Shanghai Punan hospital from March 2007 to July 2008, aged 60 and older, with no severe hepatosis and renal disfunction, and without using VitB12 preparation for 3 months, were included in the study. The levels of serum VitB12, folate, homocysteine（Hcy） were tested to screened patients with VitB12 deficiency. The results of symptoms, positive signs of neurological system and the laboratory examination were analysed and compared between patients with or without VitB12 deficiency. Results There were 827 patients, with the mean age of （ 77. 1 ±7.5 ） years old, fulfilled the enrolling criteria. VitB12 deficiency was found in 163 patients （ 19.7% ）. The prevalence was higher in female （21.9%） than male （17.4%）, which had a tendency of increased with age. In the patients with VitB12 deficiency, the rate of complicating gastrointestinal diseases was higher. Compared with patients with normal serum VitB12 level, there were more cases suffered from unstable gait （27.0%）, hypopallesthesia （34.4%）, and more cases combined with some chronic diseases such as cerebral infarction （62.6%）, hypertension （68.7%）, coronary heart disease （39.9%）. 77% cases had neuroelectricphysiological abnormalities, but only 9. 82% cases had megaloblastic anemia. Conclusions VitB12 deficiency is common in elderly inpatients in neurology department, whose clinical .manifestations are various and atypical, and the neurological symptoms are more common than megaloblastic anemia.
出处
《临床神经病学杂志》
CAS
北大核心
2009年第3期164-167,共4页
Journal of Clinical Neurology
基金
上海市浦东新区医学领先人才培养课题(PWR2006-09)
上海市浦东新区科技发展基金创新基金攻关课题(PKJ2008-Y09)
关键词
神经科老年患者
维生素B12
缺乏
elderly patients in department of neurology
vitamin B 12 deficiency
