56例巨幼细胞性贫血临床实验室特点分析

Analysis of clinical and laboratory features of patients with megaloblastic anemia

目的分析巨幼细胞性贫血(megaloblastic anemia,MA)患者的临床及实验室指标并探讨其临床意义。方法对56例巨幼细胞性贫血患者的临床和肝功能、心肌酶谱、血象和血清造血原料等实验室指标进行回顾性分析。结果 56例患者中48例(85.7%)维生素B12缺乏、5例(8.9%)叶酸缺乏;51例(91.1%)出现贫血伴白细胞和(或)血小板减少,31例(55%)平均红细胞体积(MCV)大于120fL;与正常对照相比,MA患者中乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)、门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)和间接胆红素(IBIL)明显增高,差异有高度显著性(P<0.01)。结论 LDH、HBDH、AST、TBIL和IBIL增高可作为巨幼细胞性贫血的临床实验室诊断的重要参考指标。

Objective To analyze the laboratory features and their clinical significance in patients with megaloblastic anemia （MA）. Methods The changes of liver function and cardiac muscle enzymes, hemogram, hemapoietic materials in 56 cases with MA were reviewed. Results 48 cases（85.7%） were found to be vitamin B12 deficient and 5 cases （8.9%） to be folic acid deficient. Besides anemia, leukopenia and（or） thrombocytopenia occurred in 51 cases （91.1%）. Mean corpuscular volume（MCV） larger than 120 fL was identified in 31 patients （55%）. Compared with normal controls, the serum levels of LDH, HBDH, AST, TBIL and IBIL obviously increased （P〈0.01）. Conclusion The increase of LDH, HBDH, AST, TBIL, IBIL and MCV could be used as important parameters for diagnosing MA.