【摘要】：目的:回顧分析我院2005年12月—2013年12月住院確診的巨幼細(xì)胞性貧血患者臨床常見檢測指標(biāo)及其葉酸/Vit B12缺乏情況,進(jìn)一步了解該疾病的特點(diǎn)。方法:(1)確定研究病例的納入與排除標(biāo)準(zhǔn)及搜集病例的時(shí)間范圍。(2)通過計(jì)算機(jī)病案管理系統(tǒng)及病案室搜集確定年限的符合納入標(biāo)準(zhǔn)的相關(guān)病例。(3)根據(jù)病例信息采集所需的基本信息和數(shù)據(jù)。(4)根據(jù)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析、得出結(jié)論。結(jié)果:1.根據(jù)統(tǒng)計(jì)分析,不同年齡組性別構(gòu)成有差異,不同性別整體之間沒有差異。2.在發(fā)病原因中,慢性胃炎和飲食差者共159例,占79.5%,占整體患者的絕大多數(shù)。3.在200例MA患者中,混合性貧血者共12例,占全部的6%。4.MA患者中、重度貧血共有176例,占88%。在葉酸與Vit B12的檢測中,至少有一項(xiàng)減少者共有168例,占了84%,其中有單一葉酸缺乏者34例,占17%,單一Vit B12缺乏者107例,占53.5%。根據(jù)統(tǒng)計(jì)分析葉酸與Vit B12的缺乏程度在各種貧血的程度中無差異。5.200例患者中,紅細(xì)胞、白細(xì)胞、血小板均正常者只有2例,但這2例患者的血紅蛋白均較正常值低。其中紅細(xì)胞異常最為常見,表現(xiàn)為計(jì)數(shù)減低,共有194例,占97%。根據(jù)統(tǒng)計(jì)分析說明葉酸與Vit B12的缺乏對紅細(xì)胞、白細(xì)胞及血小板的影響差異有統(tǒng)計(jì)學(xué)意義。6.在外周血直接及間接膽紅素的測定中,至少有一項(xiàng)異常者共144例,共占72%。7.167例MA患者中122例糖類抗原15-3呈陽性,占73.1%。根據(jù)統(tǒng)計(jì)分析得出:①葉酸與CA15-3檢查結(jié)果相關(guān),葉酸不缺乏時(shí)CA15-3陽性的可能性越大;②維生素B12與CA15-3檢查結(jié)果相關(guān),維生素B12缺乏時(shí)CA15-3陽性的可能性越大。結(jié)論:1.200例MA患者維生素B12缺乏占多數(shù)。葉酸與Vit B12的缺乏程度對于貧血的嚴(yán)重程度無影響。2.巨幼貧病人中葉酸與Vit B12的缺乏對紅細(xì)胞、白細(xì)胞及血小板均有影響,對紅細(xì)胞影響最大。MA貧血以中重度為主。3.CA15-3與葉酸、Vit B12均相關(guān)。
[Abstract]:Objective: to study the clinical features of megaloblastic anemia (MPA) diagnosed in our hospital from December 2005 to December 2013 and its deficiency of folic acid / Vit B12. Methods: (1) to determine the inclusion and exclusion criteria of the study cases and the time range of collecting cases. (2) to determine the relevant cases according to the inclusion criteria through the computer medical record management system and the medical record room. The basic information and data needed for the collection of case information. (4) Statistical analysis based on data, come to conclusion The result is 1: 1. According to the statistical analysis, the gender composition of different age groups is different, and there is no difference between different gender groups. 2. 2. Among the causes, 159 cases (79. 5%) were chronic gastritis and poor diet, accounting for 3. 3% of the total number of patients. Of the 200 patients with MA, there were 12 cases of mixed anemia, accounting for the total number of 6%.4.MA patients, 176 cases of severe anemia, accounting for 88%. In the detection of folic acid and Vit B12, there were at least one item of decrease in 168 cases, accounting for 84 cases, of which 34 cases were single folic acid deficiency (17 cases) and 107 cases were single Vit B12 deficiency (53.5%). According to statistical analysis, there was no difference in the degree of folic acid deficiency and Vit B12 deficiency in all kinds of anemia. In 5.200 patients, only 2 patients had normal erythrocytes, white blood cells and platelets, but the hemoglobin levels of these two patients were lower than those of normal patients. The most common abnormality of erythrocyte was the decrease of count, 194 cases (97. 7%). According to statistical analysis, the effect of folic acid and Vit B12 deficiency on erythrocyte, leukocyte and platelets was significantly different. In the determination of direct and indirect bilirubin in peripheral blood, there was at least one abnormality in 144 cases, accounting for 72% of 7.167 cases of MA. 122 cases (73.1%) were positive for carbohydrate antigen 15-3. According to the statistical analysis, the results of folic acid and CA15-3 were related, the possibility of positive CA15-3 was higher when folic acid was not deficient, and the possibility of CA15-3 positive with vitamin B12 was higher when vitamin B12 was deficient. Conclusion: vitamin B 12 deficiency accounts for the majority in 1.200 patients with MA. The deficiency of folic acid and Vit B12 had no effect on the severity of anemia. The deficiency of folic acid and Vit B12 affected erythrocytes, white blood cells and platelets, but had the greatest effect on erythrocytes in megaloblastic patients. MA anemia was mainly moderate and severe. 3.CA15-3 was correlated with folic acid and Vit B12.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R556

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