摘要
目的分析维生素B12(Vitamin B12,VB12)缺乏相关复发性口腔溃疡患者的临床特点及治疗体会,以期提高临床疗效。方法回顾性分析2016年1月-2018年9月15例复发性口腔溃疡患者,结合其临床特点,对其原因进行分析。结果 15例复发性口腔溃疡患者均有常规免疫类药物治疗后无缓解。血常规发现红细胞平均体积明显升高,平均红细胞数目及血红蛋白下降,进一步血清学检测后证实维生素B12水平降低,叶酸和铁蛋白含量正常,服用甲钴胺一个月后再次复查口腔情况,15例患者溃疡均未再复发。复查血常规可见红细胞平均体积恢复至正常范围内,与治疗前相比差异具有统计学意义(P <0.001);红细胞和血红蛋白较前有所升高并恢复至正常水平,差异也有统计学意义(P <0.01);治疗前后血清中维生素B12水平与治疗前相比改善,差异具有统计学意义(P <0.001)。结论维生素B12缺乏症以复发性口腔溃疡症状为主要表现时,口腔医师通过仔细检查病损,详细询问病史,必要时行进一步血清学检测,避免过度使用免疫抑制类药物进行治疗。
Objective To analyze the clinical characteristics and treatment experience of Vitamin B12(VB12) deficient patients with recurrent aphthous ulcers(RAU) to improve the clinical efficacy. Methods A retrospective analysis was performed on 15 cases of recurrent oral ulcers from January 2016 to September 2018. The causes were analyzed according to the patients’ clinical characteristics. Results In total, 15 patients with RAU had no remission after routine immunotherapy. Further clinical examination suggested that vitamin B12 levels were reduced. The erythrocyte mean corpuscular volume(MCV) was significantly increased, and the average number of red blood cells(RBC) and hemoglobin(Hb) levels were decreased. RAU disappeared after vitamin B12 supplementation. Routine blood work showed that the MCV returned to the normal range, which was statistically significant compared with the pretreatment MCV(P < 0.001).Vitamin B12 serum levels were significantly higher(P < 0.001) than those before treatment. Conclusion When the main manifestation of vitamin B12 deficiency is recurrent oral ulcer symptoms, dentists should examine the lesions carefully, inquire about the medical history in detail, and perform further serological tests when necessary to avoid the overuse of immunosuppressive drugs for treatment.
作者
孟文霞
冯璐
资云玲
蒋李懿
李菊兄
周震
MENG Wenxia;FENG Lu;ZI Yunling;JIANG Liyi;LI Juxiong;ZHOU Zhen(Department of oral mucosa,Stomatological Hospital, Southern Medical University, Guangzhou 510280, China;Department of implant dentistry, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China)
出处
《口腔疾病防治》
2019年第6期370-374,共5页
Journal of Prevention and Treatment for Stomatological Diseases
基金
国家自然科学基金项目(81500850)
国家卫生计生委公益性行业专项(201502018
