Objective: To investigate the status of vitamin B12 deficiency in elderly inpatients in the department of neurology.
Methods: A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1+/-7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B12 during the previous 3 months before the detection. The levels of serum vitamin B12, folate and homocysteine (Hcy) were evaluated. The patients with vitamin B12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B12 deficiency.
Results: Vitamin B12 deficiency was found in 163 patients (19.71% of the total patients), and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B12 deficient patients had megaloblastic anemia. Symptoms of vitamin B12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson's disease (Parkinsonism), diabetes mellitus and coronary heart disease. Most of the vitamin B12 deficient patients had neuroelectricphysiological abnormalities.
Conclusion: Vitamin B12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.
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岁的患者进行血清叶酸、 VitB12、 同型半胱氨酸(Hcy)等指标的检测, 筛查VitB12缺乏者。 共827例患者入组, 平均年龄77.1±7.5岁。 所有患者均无严重肝肾功能障碍, 且近3个月内未补充VitB12。 对VitB12正常患者和缺乏患者的神经系统症状、 体征及神经电生理检查结果进行比较和分析。
结果: VitB12缺乏者有163例(占所有患者总数的19.71%), 神经电生理检查多有异常, 患病率女性高于男性, 并随年龄增长有增加的趋势。 VitB12 缺乏患者更易出现行走不稳及振动觉减退等症状, 巨红细胞贫血仅为9.82%。 VitB12缺乏患者更易出现行走不稳 及振动觉减退等症状, 更多还伴有脑梗死、 高血压、 冠心病等慢性疾病。
结论: 神经科住院老年患者常伴有VitB12缺乏症, 症状表现多样, 神经系统表现较之巨红细胞贫血更常见。