以消化道症状为主要表现的维生素B12缺乏症临床分析

摘要

Objective To analyze risk factors and clinical characteristics of vitamin bl2 deficiency mainly presenting digestive symptoms. Methods Analyze 11 gastroenterology department hospitalized patients presenting diarrhea, nausea vomiting and so on digestive system symptoms, finally diagnosed as vitamin bl2 deficiency from 2008 to 2010. Results 9 patients had risk factors of vitamin bl2 deficiency. Vegetarian, surgery, and taking drugs which can inhibit the absorption of vitamin bl2 were included. There were 5 patients presenting chronic diarrhea. 2 patients presenting nausea and vomit. 4 patients presenting abdominal distension and loss of appetite. Low serum vitamin B12 levels, great mean corpuscular volume and high mean corpuscular hemoglobin concentration were found in all patients. With diet supplement and treatment Of intramuscular vitamin bl2 injection, the related symptoms of all patients were disappeared. Conclusion Vitamin bl2 deficiency can present digestive symptoms. It should be noted and identified in clinical practice to reduce mis-diagnosis and missed diagnosis.%目的 分析以消化道症状为主要表现的维生素B12(VB12)缺乏症患者病因及临床特点,减少其误诊及漏诊率.方法 对以恶心、呕吐等消化道症状为表现而收入医院消化内科住院并最后确诊为VB12缺乏的11例患者进行分析.结果 11倒患者中9例存在影响维生素B12摄入或吸收的危险因素,包括素食(5例)、手术(2例)及服用可抑制VB12吸收的药物(2例)等.主要以慢性腹泻(5例)、恶心、呕吐(2例)、腹胀及食欲减退(4倒)等为临床表现.11例患者血清维生素B12水平降低,平均红细胞体积及平均红细胞血红蛋白量均明显升高,经饮食调整及补充维生素B12后症状逐渐消失.结论 VB12缺乏症可以消化道症状为主要表现.临床应注意识别该类患者,以减少误诊及漏诊.