高齢者の貧血

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タイトル別名
  • Anemia in the Aged
  • コウレイシャ ノ ヒンケツ

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The peripheral blood figures and incidence of anemia were investigated and types of anemia in hospital patients were studied in the aged. The results obtained were as follows:<br>1) Hemoglobin concentration, red blood cell counts and thrombocyte counts were shown to decrease in the aged. Of the erythrocytic indices, MCHC decreased, but MCV increased in the aged. As the criterion foranemia in the aged, hemoglobin concentration of less than 11.2 or RBC less than 3.5 million appeared to be adequate. The incidence of anemia in healthy subjects who lived at home was 11% in male and 13% in female. On the other hand, in hospital patients, that was 33% in male and 53% in female, respectively.<br>2) High incidence of anemia in the aged hospitalized were observed not only in patients with hematological diseases, liver diseases, gastrointestinal bleedings, malignancies and infections, but also in patients with cerebrovascular diseases, cardiovascular diseases and fractures which made them tend to the bedridden.<br>3) Seventy two females and 29 males with mild, moderate or severe anemia were classified into irondeficiency, folate-deficiency, B12-deficiency and miscellaneous anemia. Iron-deficiency anemia was found in 36 patients (36%). All of 12 patients whose percentage iron-binding saturation was less than 16% were treated with iron, and the remaining 24 patients recieved treatment against the underlied disease. Sixteen patients showed an adequate response and 20 patients achieved a normal level. Folate-deficiency anemia found 17 patients (17%) and 11 patients of them were associated with iron-deficiency. All of the cases received folate therapy and only 5 patients showed an adequate response, 3 patients achieved a normal level and 5 patients died. There were some folate-deficiency anemia which had a few megaloblast in bone marrow showed hypersegmented neutrophils. No B12-deficiency anemia was found in our series studied. This finding was thought to be due to medicate vitamines in most of hospital patients. Miscellaneous anemia was found in 48 patients (48%). Some cases were with subnormal levels of serum B12 and folate, and with hypersegmented neutrophils, and with macrocytic anemia. This finding suggested that some patients with miscellaneous anemia would become B12-deficiency or folate-deficiency anemia in future.<br>These findings suggest the aged have a tendency to become anemic in various disease and the effect of anemia is more serious in elderly patients than younger ones, and so, anemia in the elderly should always be checked. The supply of B12 and folate would be necessary for the bedridden patients who are not able to have diet sufficiently.

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