【摘要】：目的:萎縮性舌炎為口腔黏膜常見(jiàn)疾病之一,病因復(fù)雜。本研究通過(guò)收集臨床病例資料,分析相關(guān)數(shù)據(jù),探索萎縮性舌炎與貧血相關(guān)因子(血常規(guī)、血清維生素B12、血清鐵蛋白、葉酸)的關(guān)系,以指導(dǎo)臨床診斷與治療。方法:收集2015年4月至2016年12月于青島大學(xué)附屬醫(yī)院口腔黏膜科主治及以上醫(yī)師診斷為萎縮性舌炎的臨床病例共33例。排除舌部念珠菌鏡檢陽(yáng)性患者,近期服用維生素、抗生素或含鐵藥物患者,干燥綜合征患者及舌背黏膜出現(xiàn)萎縮性改變的其他疾病(如地圖舌、口腔扁平苔蘚、正中菱形舌、放射性口炎等)的患者。檢測(cè)萎縮性舌炎患者的血常規(guī)、血清維生素B12、血清鐵蛋白及葉酸水平。對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,采用百分率來(lái)表示各數(shù)據(jù)之間的大小關(guān)系。探索萎縮性舌炎與貧血相關(guān)因子的關(guān)系。結(jié)果:33例萎縮性舌炎患者中,男女比例為1:4.5,最低年齡32歲,最高年齡80歲,平均年齡57.9歲,50-60歲有12人,60-70歲有10人,共計(jì)22人,占66.67%;33例萎縮性舌炎患者中,血紅蛋白、紅細(xì)胞計(jì)數(shù)、紅細(xì)胞比容指標(biāo)出現(xiàn)異常者共計(jì)19人,占57.58%;33例萎縮性舌炎患者中,維生素B12缺乏16人次,占48.5%,血清鐵蛋白缺乏10人次,占30.3%,其中維生素B12、血清鐵蛋白均缺乏4例,占12.12%;33例萎縮性舌炎患者葉酸水平均正常;7例大細(xì)胞性貧血患者均有維生素B12缺乏,4例小細(xì)胞低色素性貧血患者均有血清鐵蛋白缺乏;14例血常規(guī)正常的萎縮性舌炎患者中,有5例出現(xiàn)維生素B12或血清鐵蛋白降低。結(jié)論:排除感染因素及其他因素,萎縮性舌炎好發(fā)于中老年女性,其發(fā)生與貧血相關(guān)因子有關(guān);在異常的貧血相關(guān)因子中,血清維生素B12缺乏比例占第一位,其次為血清鐵蛋白缺乏;本研究未發(fā)現(xiàn)萎縮性舌炎的發(fā)生與葉酸缺乏有關(guān);維生素B12缺乏或血清鐵蛋白缺乏引起的舌乳頭萎縮可能會(huì)早于血常規(guī)指標(biāo)的改變。
[Abstract]:Objective: atrophic glossitis is one of the common diseases of oral mucosa. In order to guide clinical diagnosis and treatment, this study investigated the relationship between atrophic glossitis and anemia related factors (blood routine, serum vitamin B12, serum ferritin, folic acid) by collecting clinical data and analyzing relevant data. Methods: from April 2015 to December 2016, 33 patients with atrophic glossitis diagnosed by oral mucosal department or above in the affiliated Hospital of Qingdao University were collected. Other diseases such as map tongue, oral lichen planus, median rhomboid tongue, and other diseases (map tongue, oral lichen planus, median rhomboid tongue), patients with Sjogren's syndrome and atrophic changes in the dorsal mucosa of the tongue are excluded. A patient with radiation stomatitis, etc. The blood routine, serum vitamin B 12, serum ferritin and folic acid levels were measured in patients with atrophic glossitis. Statistical analysis of the data, the use of percentages to represent the size of the relationship between the data. To explore the relationship between atrophic glossitis and anemia related factors. Results: among 33 patients with atrophic glossitis, the ratio of male to female was 1: 4.5, the minimum age was 32 years old, the highest age was 80 years old, the average age was 57.9 years old, there were 12 patients aged 50-60 years and 10 patients aged 60-70 years. In 33 patients with atrophic glossitis, 19 patients (57.58) had abnormal hemoglobin, erythrocyte count and erythrocyte specific volume index. In 33 patients with atrophic glossitis, there were 16 cases of vitamin B12 deficiency (48.5%), 10 cases of serum ferritin deficiency (30.3%), and 4 cases of vitamin B12 and serum ferritin deficiency (12.12%). The levels of folic acid were normal in 33 patients with atrophic glossitis, vitamin B12 deficiency was found in 7 patients with macrocytic anemia and serum ferritin deficiency in 4 patients with small cell hypochromic anemia. Of 14 patients with atrophic glossitis with normal blood routine, 5 had vitamin B 12 or decreased serum ferritin. Conclusion: the incidence of atrophic glossitis in middle-aged and elderly women is related to anemia related factors, excluding infection factors and other factors. Among the abnormal anemia related factors, the proportion of serum vitamin B12 deficiency was the first, followed by the serum ferritin deficiency, and there was no relationship between the occurrence of atrophic glossitis and folic acid deficiency in this study. Tongue papilla atrophy caused by vitamin B 12 deficiency or serum ferritin deficiency may be earlier than the change of blood routine.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R556;R781.57

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