双下肢乏力伴叶酸缺乏患者临床特征的研究  

Study on the clinical characteristics of patients with lower extremity weakness and folic acid deficiency

作　　者：余爱勇 薛冬梅 杨柳 赵迎春[1] 周克贵 YU Aiyong;XUE Dongmei;YANG Liu;ZHAO Yingchun;ZHOU Kegui(Department of Neurology,Shanghai Songjiang District Central Hospital,Shanghai 201699,China)

机构地区：[1]上海市松江区中心医院神经内科,上海201699

出　　处：《广州医药》2023年第8期22-28,共7页Guangzhou Medical Journal

基　　金：松江区科学技术攻关项目(22SJKJGG74)。

摘　　要：目的 总结以双下肢乏力为主要表现的、合并低叶酸血症的患者的临床特征。方法 选择自2017年1月—2020年12月在我院神经内科住院的患者,分为3组:双下肢乏力伴叶酸缺乏组,共23例;叶酸缺乏合并脑血管病组,共129例;叶酸缺乏的健康体检者,为来我院行健康体检、无意中发现叶酸水平降低者,共42例,比较3组患者特征。结果 双下肢乏力伴叶酸缺乏组患者的发病年龄在19~88岁之间,平均(63.82±20.24)岁,男女比为2.3∶1。起病时间(13.34±17.88)d。与叶酸缺乏合并脑血管病组以及与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者脑叶缺血灶数量较少,差异有统计学意义,P分别=0.001和0.008;与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者放射冠和侧脑室缺血灶数量无变化,差异无统计学意义,P>0.05;与叶酸缺乏合并脑血管病组以及与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者整体脑组织缺血灶总数较少,差异有统计学意义,P分别<0.01和0.05。结论 临床上遇到双下肢乏力患者,尤其是发病年龄在63岁左右,男性,起病时间在13 d左右,颅内整体缺血灶、尤其脑叶缺血灶较少的患者,需要警惕低叶酸血症所致双下肢乏力的可能。Objective To summarize the clinical characteristics of patients with lower extremity weakness as the main manifestation and hypofolicemia.Methods Patients admitted in our neurology inpatient center from January 2017 to December 2020 were selected and divided into 3 groups.Group A consisted of 23 cases of bilateral lower extremity weakness combined with folic acid deficiency.Group B consisted of 129 cases of folic acid deficiency combined with cerebrovascular disease.Group C consisted of 42 healthy people with folic acid deficiency who came to our hospital for health check-up and found that the level of folic acid was decreased accidentally.The clinical characteristics of the three groups of patients were compared.Results The age of onset in group A was between 19 and 88 years old,with an average of(63.82±20.24)years old,and the male to female ratio was 2.3∶1.The onset time was(13.34±17.88)days.Compared with the group B and group C,the number of cerebral lobe ischemic area in group A was lesser,and the difference was statistically significant,P=0.001 and 0.008,respectively.Compared with group C,the number of corona radiata and lateral ventricle ischemic lesions in group A did not change,and the difference was not statistically significant,P>0.05.Compared with group B and group C,the total number of ischemic lesions in the overall brain tissue of group A was lesser,and the difference was statistically significant,P<0.01 and P=0.05 respectively.Conclusions When we encounter patients with bilateral lower extremity weakness in clinical practice,especially the average age of onset is around 63 years old,male,the onset time is about 13 days,and the overall intracranial ischemic lesions,especially the lobar ischemic lesions are less,we need to think of the possibility of bilateral lower extremity weakness caused by hypofolate.

关 键 词：叶酸 脑缺血 乏力 

分 类 号：R591[医药卫生—内科学] R743[医药卫生—临床医学]