Blood examination is necessary for oral mucosal disease patients.
Blood examination is necessary for oral mucosal disease patients.
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对于口腔粘膜疾病患者来说，血液检查是必要的。
DOI：
10.1016/j.jfma.2015.08.010
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
C. Chiang
中科院分区：
文献类型：
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作者：
A. Sun;Julia Yu;C. Chiang
根据世界卫生组织（WHO）的定义，贫血或血红蛋白缺乏症的定义是男性血红蛋白浓度< 13 g/dL，女性< 12 g/dL。1缺铁（血清铁水平< 60 μg/dL）可能导致缺铁性贫血。1维生素B12缺乏（血清维生素B12水平< 200 pg/mL）或叶酸缺乏（血清叶酸水平< 4 ng/mL）可导致大红细胞性贫血。2 e4此外，维生素B12和/或叶酸的缺乏可能导致血清同型半胱氨酸水平异常高（> 12.4 μM）。5 e9血清胃壁细胞自身抗体（GPCA）阳性可诱导胃壁细胞破坏，随后导致内源性因子的产生和末端回肠对维生素B12的吸收失败，最终导致维生素B12缺乏。2 e4由于贫血和血液缺乏可能导致或加重口腔粘膜疾病，如萎缩性舌炎（AG）、灼口综合征（BMS）、口腔扁平苔藓（OLP）、复发性阿弗他溃疡（RAU）或口腔粘膜下纤维化（OSF），在我们的口腔粘膜疾病诊所，全血细胞计数、血清铁、维生素B12、叶酸和同型半胱氨酸水平，血清GPCA滴度通常用于检查这5种疾病患者是否存在小细胞、正常细胞或大细胞贫血，是否存在血细胞缺乏，是否存在血清同型半胱氨酸水平异常升高，是否存在血清GPCA阳性。5 e9对上述五种口腔粘膜疾病患者进行血液检查后，我们发现176名AG患者中血红蛋白、铁、维生素B12和叶酸缺乏的比例分别为22.2%、26.7%、7.4%和1.7%，399名BMS患者中分别为22.3%、20.3%、2.5%和1.5%，在352例OLP患者中分别为21.9%、13.6%、7.1%和0.3%的6例，在273例RAU患者中分别为20.9%、20.1%、4.8%和2.6%的7例，在68例男性OSF患者中分别为7.4%、20.6%、50.0%和41.2%的9例。176例AG患者中21.6%、399例BMS患者中22.3%、352例OLP患者中14.8%、273例RAU患者中7例、7.7%血清同型半胱氨酸水平异常增高。8.176例AG患者血清GPCA阳性率为26.7%，399例BMS患者血清GPCA阳性率为13.3%，68例男性OSF患者血清GPCA阳性率为6%，13.2%。9此外，AG和BMS患者的血红蛋白、铁或维生素B12缺乏、血液同型半胱氨酸水平异常升高或血清GPCA阳性的频率显著高于健康对照个体。5、6 OLP患者血红蛋白、铁或维生素B12缺乏以及血液高半胱氨酸水平异常高的频率明显高于健康对照人群。RAU患者血红蛋白、铁、维生素B12或叶酸缺乏以及异常高的血液同型半胱氨酸水平的频率显著高于健康对照个体。8男性OSF患者的血红蛋白、维生素B12或叶酸缺乏以及血清GPCA阳性的频率显著高于健康对照个体。9因此，约21.1%、19.3%、7.5%、3.5%、16.7%和
According to the World Health Organization (WHO), anemia or hemoglobin deficiency is defined as having a hemoglobin concentration< 13 g/dL for men and< 12 g/dL for women. 1 Iron deficiency (serum iron level< 60 μg/dL) may lead to iron deficiency anemia. 1 Vitamin B12 deficiency (serum vitamin B12 level< 200 pg/mL) or folic acid deficiency (serum folic acid level< 4 ng/mL) may result in macrocytic anemia. 2 e4 Moreover, deficiencies of vitamin B12 and/or folic acid may lead to abnormally high serum homocysteine level (> 12.4 μM). 5 e9 Serum gastric parietal cell autoantibody (GPCA) positivity may induce destruction of gastric parietal cells and subsequently result in failure of production of intrinsic factor and absorption of vitamin B12 from the terminal ileum, finally leading to vitamin B12 deficiency. 2 e4 Because anemia and hematinic deficiencies may cause or aggravate oral mucosal diseases such as atrophic glossitis (AG), burning mouth syndrome (BMS), oral lichen planus (OLP), recurrent aphthous ulcerations (RAU), or oral submucous fibrosis (OSF), in our oral mucosal disease clinic, complete blood count, serum iron, vitamin B12, folic acid and homocysteine levels, and serum GPCA titers are usually examined to check whether patients with these 5 diseases have microcytic, normocytic or macrocytic anemia, deficiencies of hematinics, abnormally high serum homocysteine level, and serum GPCA positivity. 5 e9 After blood examination of patients with the five abovementioned oral mucosal diseases, we found that deficiencies of hemoglobin, iron, vitamin B12 and folic acid can be detected in 22.2%, 26.7%, 7.4%, and 1.7% of 176 AG patients, 5 in 22.3%, 20.3%, 2.5%, and 1.5% of 399 BMS patients, 6 in 21.9%, 13.6%, 7.1%, and 0.3% of 352 OLP patients, 7 in 20.9%, 20.1%, 4.8%, and 2.6% of 273 RAU patients, 8 and in 7.4%, 20.6%, 50.0%, and 41.2% of 68 male OSF patients, 9 respectively. Moreover, abnormally high serum homocysteine levels can be discovered in 21.6% of 176 AG patients, 5 in 22.3% of 399 BMS patients, 6 in 14.8% of 352 OLP patients, 7 and in 7.7% of 273 RAU patients. 8 In addition, serum GPCA positivity can be recognized in 26.7% of 176 AG patients, 5 in 13.3% of 399 BMS patients, 6 and in 13.2% of 68 male OSF patients. 9 Furthermore, AG and BMS patients have a significantly higher frequency of hemoglobin, iron or vitamin B12 deficiency, of abnormally elevated blood homocysteine level, or of serum GPCA positivity than healthy control individuals. 5, 6 OLP patients have a significantly higher frequency of hemoglobin, iron, or vitamin B12 deficiency and of abnormally high blood homocysteine level than healthy control individuals. 7 RAU patients have a significantly higher frequency of hemoglobin, iron, vitamin B12, or folic acid deficiency and of abnormally high blood homocysteine levels than healthy control individuals. 8 Male OSF patients have a significantly higher frequency of hemoglobin, vitamin B12, or folic acid deficiency and of serum GPCA positivity than healthy control individuals. 9 Therefore, approximately 21.1%, 19.3%, 7.5%, 3.5%, 16.7% and