23例国人烟酸缺乏病报道综合分析

Meta-analysis of 23 case reports of pellagra in China

目的了解我国烟酸缺乏病患者的临床表型特点及诊治相关问题。方法对1例不典型烟酸缺乏病患者的诊治过程进行详细报道,并对近年国内发表的资料完整的22例烟酸缺乏病患者进行综合对比分析。结果①报道患者以男性居多,成年患者构成比高,但儿童和老年也可累及,病程多为慢性;②常见诱因为酗酒、偏食,少数与服药等特殊因素有关,日晒是皮炎发生的主要促发因素;③不同患者临床表现中,皮炎、腹泻和神经精神症状可出现不同组合方式;④依据临床表现是主要的诊断方式,临床容易误诊;⑤治疗方案为特异性,一旦确诊常可达到良好的疗效。结论烟酸缺乏病在临床上并不罕见,但临床表型存在很大差异性与隐匿性,容易导致误诊误治,值得临床关注。

Objective To understand the clinical features, phenotypes, diagnosis and treatment of Chinese patients with pellagra. Methods We analyze and report detail clinical information of a young female patient with untypical pellagre, and perform a meta-analysis for other 22 selected patients with pellagra reported in recent 10 years. Results Pellagra is a most remarka- ble disease of chronic process which involve mostly adult male patients, and it could occur during infancy as well. Pellagra could occur under some special conditions such as chronic alcoholism , dietary bias and drug abuse. The photosensitivity reaction may be the important factor. The clinic triad of pellagra is sometimes too complex to reach the accurate diagnosis. Conclusions Pellagra is not a rare disease even in recent years, much attentions should be indispensable in establish the more reliable understanding of pellagra.