巨幼细胞贫血所致黄疸分析

目的分析巨幼细胞贫血（MA）患者的血清胆红素浓度改变。方法选择47例经骨髓象检查确诊的初诊MA患者，另选取41例无贫血健康人员作为对照组。结果MA组、对照组直接胆红素（DBil）均数分别为（9．07±4．43）μmol／L及（3．614±1．29）μmol／L，P〈0．0001；两组间接胆红素（IBil）中位数分别为18．950μmol／L、7．340μmol／L，P=0．0000。MA患者中，37例（78．72％）总胆红素（TBil）〉17．μmol／L，13例（27．66％）TBil〉34．2μmol／L，30例（63．83％）DBil〉6．8μmoL／L，最大值为19．42μmoL／L，36例（76．60％）IBil〉14．0μmol／L，最大值为98．07μmol／L。37例伴黄疸MA患者中，4例（10．81％）DBiL／TBil〈0．20，33例（89．19％）DBil／TBil为0．20～0．50。结论MA患者中，近3／4者TBil升高，近3／10呈显性黄疸，近9／10者MA黄疸类似肝细胞性黄疸，需与肝病相鉴别。

Jaundice of megaloblastic anemia

Objective To analyze the changes of serum bilirubin concentration in megaloblastic anemia（MA） patients. Methods Forty- seven MA patients were newly diagnosed by bone marrow ex- amination and 41 healthy people without anemia were as controls. Results The mean of serum direct bilirubin concentration （DBil） of MA patients and controls was （9.07±4.43）μmol/L, （3.61± 1.29）μmol/L, respectively （ P 〈0. 0001 ）. The two groups median of serum indirect bilirubin concentration （IBil） was 18. 950 txmol/L, 7. 340 μmol/L, respectively （ P =0. 0000）. Serum total bilirubin concentration （TBil） of 37 MA patients（78.72% ） were 〉 17.1 kLmol/L. TBil of 13 MA patients（27.66% ） were 〉 34.2 μmol/L. DBil of 30 MA patients （63.83%） were 〉 6.8 p~mol/l,, the maximum was 19.42 μmol/L. IBil of 36 MA patients （76.60%） were 〉 14.0 μmol/L, the maximum was 98.07 μmol/L. In 37 MA patients with jaundice, the ratio of DBil to TBil in 4 cases（ 10.81% ） were less than 0.20, whereas the ratio of 33 cases（89.19% ） were between 0.20 and 0.50. Conclusions TBil of about three fourths MA patients increases. Clinical jaundice appears in about three tenths of MA patients. Jaundice of about nine tenths of MA patients is similar to hepatocellular jaundice, which should be differentiated from liver diseases.