不同剂量维生素A强化饼干对3-6岁儿童维生素A营养状况的干预效果

背景：维生素A缺乏性疾病是一个世界性的儿童健康问题，中国西部及边远地区尤为严重，需要进行营养干预。 目的：比较补充3种不同剂量强化维生素A饼干对3—6岁儿童维生素A营养状况的改善效果，探索预防维生素A缺乏性疾病的强化饼干的理想剂量。 设计：随机对照观察。 单位：重庆市卫生局卫生监督所、重庆医科大学公共卫生学院营养与食品卫生学教研室和重庆医科大学儿童医院儿童营养研究中心。 对象：调查于2002—03／12完成，选择重庆市巴南区8个幼儿园的3-6岁儿童753名，监护人均知情同意。随机分为4组，即30％推荐摄入量组、100％推荐摄入量组、2万国际单位组及20万国际单位组。 方法：①30%推荐摄入量组（177名）每日补充维生素A30％每日推荐摄入量（500IU）强化饼干1次。②100％推荐摄入量组（173名）每日补充维生素A100％每日推荐摄入量（1666IU）强化饼干1次。③2万国际单位组（209名）每周补充维生素A2万国际单位强化饼干1次。④20万国际单位组（194名）补充维生素A20万国际单位胶丸1次。所有儿童干预前及干预3个月时测定身高、体质量、血清视黄醇、前白蛋白、血红蛋白及视黄醇结合蛋白。30％推荐摄入量组中有87名儿童在补充9个月后再次复查以上指标。 主要观察指标：①各组儿童干预前及干预3个月后维生素A缺乏性疾病检出率。②各组儿童干预前及干预3个月后血清视黄醇、血清前白蛋白、血清视黄醇结合蛋白、血红蛋白、身高和体质量。 结果：因样本流失和检测技术的问题，复查仅得580名儿童的检测结果。①各组儿童维生素A缺乏性疾病检出率比较：补充3个月后，30％推荐摄入量组、100％推荐摄入量组、2万国际单位组及20万国际单位组儿童维生素A缺乏性疾病检出率均较治疗前显著下降[1.48％，1．42％，1.21％，2．16％；6．78％．6．54％,8．61％。8．25％（X^2=3．86-8．57，P〈0．05-0．01）]。②各组儿童血清视黄醇、血清前白蛋白、血清维生素A、血红蛋白、身高和体质量比较：补充3个月后，自身对照除30％推荐摄入量组的前白蛋白和血红蛋白外。各组儿童其余各项指标均明显增加（t=2．52-37．44，P〈0．05-0．01）。2万国际单位组血清维生素A的升高幅度明显大于其他组（F=4．62，P〈0．01），30％推荐摄入量组血红蛋白、前白蛋白和身高的增长幅度明显小于其他组（F=5．0-7．78，P〈0．01）。30％推荐摄入量组补充9个月后，血红蛋白和前白蛋白的升高明显大于其余组（F=11．62，10.21，P〈0．01），血清视黄醇的升高仍低于2万国际单位组（F=4．21，P〈0．01）。 结论：补充3种不同剂量的维生素A强化饼干和20万国际单位维生素A胶丸，均可明显改善维生素A的营养状况和血红蛋白水平。其中30％推荐摄入量和100％推荐摄入量风险小、且每日补充能稳定维持体内维生素A水平，可能是更适于儿童的长期补充剂量，而30％推荐摄入最优于100％推荐摄入量。     

南昌市部分人群的维生素A营养状况调查

目的 为了全面了解维生素A的营养状况,对老年人和大学生的维生素A的摄入量和血清水平做了调查.方法 调查了某福利院60名60岁以上的老人,其中男性35人,女性25人;调查124名年龄18～20岁的大学生,男生61人,女生63人.用称重法对老年人做4天膳食调查;以回顾性问卷调查做了大学生的膳食调查.以改进微量荧光法测定调查对象的血清维生素A含量.结果 维生素A(视黄醇当量)摄人量为414～485μg/day,占RNI的51.75%～64.3%.老年人血清维生素A含量的平均水平为1.26±0.47 μmol/L;大学生血清维生素A平均水平为1.27±0.23 μmol/L;没有发现临床维生素A缺乏者.维生素A正常者占82.39%,老年人中有46.15%,大学生97.58%,差异有统计学显著意义.结论 本次调查未发现临床维生素A缺乏者,但是17.61%有程度不同的缺乏,视黄醇当量摄入量不足是导致缺乏的原因,必须加强营养,普及营养知识.     

个性化膳食指导对孕妇维生素A摄入量的影响

[目的]了解孕妇维生素A摄入现状,探讨个性化的饮食指导对孕妇维生素A摄入量的影响.[方法]选择参加孕期营养跟踪的孕妇108例,分别在营养指导前、后进行连续5 d膳食称重记录并填写膳食调查表,将膳食调查数据输入计算机营养分析软件(孕妇版).[结果]指导前孕妇维生素A摄入量的差异性较大,维生素A摄入量未达到预防维生素A缺乏最低标准的占48.15%;超过预防维生素A缺乏最低标准但未达到适宜供给量的占22.22%;达到适宜供给量的占11.11%;超过适宜供给量但未达到可耐受最高摄入量的占12.96%;超过可耐受最高摄入量的占5.56%.指导后孕妇维生素A的摄入量基本达到适宜摄入量.个性化膳食指导前孕妇维生素A的摄入量差异性较大,摄入量不足的比例较高,个性化膳食指导后与指导前相比差异具有统计学意义(P<0.05).[结论]孕妇进行个性化膳食指导后维生素A的摄入量基本接近营养推荐量,维生素A的适量摄入有利于孕妇健康及胎儿的生长发育,对孕妇进行维生素A相关知识指导的孕期保健措施值得推广.     

佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析

目的了解黑龙江佳木斯地区6岁以下儿童血清维生素A(Vit A)、25-羟基维生素D[25(OH)D]、维生素E(Vit E)水平,为临床高危年龄段人群合理补充Vit A、维生素(Vit D)、Vit E及预防相关疾病的发生提供参考。方法将5 169名6岁以下儿童按年龄分为1岁组(732名)、1~岁组(831名)、2~岁组(693名)、3~岁组(1 164名)、4~岁组(1 008名)、5~岁组(741名)。完成问卷调查,抽取静脉血,采用高效液相色谱法检测血清Vit A、Vit E水平,采用高效液相色谱串联质谱法检测血清25(OH)D水平。结果 5 169名6岁以下儿童血清Vit A水平为(0.28±0.087)mg/L、不足率为54.09%、缺乏率为13.46%,不同年龄段血清Vit A水平差异有统计学意义(F=4.370,P=0.001),其中1岁组血清Vit A水平最低[(0.25±0.071)mg/L],不足率为61.48%、缺乏率为19.67%。血清25(OH)D水平为(24.20±9.97)ng/mL,不足率为18.57%、缺乏率为17.99%;随着年龄的增大,血清25(OH)D水平逐渐降低。血清Vit E平均水平为(8.68±2.49)mg/L,不足率为21.53%,缺乏率为0.58%,随着年龄的增大,血清Vit E水平呈减低趋势。结论佳木斯地区6岁以下儿童Vit A、25(OH)D水平不容乐观,需要针对高危年龄段人群及时检测、合理补充,以预防维生素缺乏症的发生,而Vit E营养状况相对良好。     

南昌市部分人群的维生素A营养状况调查

目的为了全面了解维生素A的营养状况,对老年人和大学生的维生素A的摄入量和血清水平做了调查。方法调查了某福利院60名60岁以上的老人,其中男性35人,女性25人;调查124名年龄18～20岁的大学生,男生61人,女生63人。用称重法对老年人做4天膳食调查：以回顺性问卷调查做了大学生的膳食调查。以改进微量荧光法测定调查对象的血清维生素A含量。结果维生素A（视黄醇当量）摄入量为414～485μg／dav,占RNI的51．75％～64.3％。老年人血清维生素A含量的平均水平为1．26±0．47μmol／L;大学生血清维生素A平均水平为1．27±0．23μmol／L：没有发现临床维生素A缺乏者。维生素A正常者占82．39％,老年人中有46．15％,大学生97．58％。差异有统计学显著意义。结论本次调查未发现临床维生素A缺乏者．但是17．61％有程度不同的缺乏．视黄醇当量摄入量不足是导敏缺乏的原因．必须加强营养普及营养知识．     

婴儿维生素A营养状况与乙型肝炎疫苗免疫效果关系的研究

目的探讨婴儿维生素A营养状况及其与乙型肝炎表面抗体水平的关系。方法通过山东省临沂市梅埠镇和蒙阴县人民医院计划免疫接种机构,采集符合纳人条件的198例婴儿静脉血2ml,对婴儿照料者进行24h膳食回顾调查和2Et膳食记录相结合的方法,了解婴儿连续72h进食的食物及数量。采用营养素计算软件,计算每人每日各种营养素的平均摄入量,并计算其占推荐摄入量（RNI）或适宜摄入量（AI）百分比。血清维生素A浓度采用高效液相色谱法测定,血清乙型肝炎病毒表面抗体浓度采用电化学发光免疫分析法（ECLIA）测定。比较亚临床维生素A缺乏组（87例）,可疑亚临床维生素A缺乏组（51例）及正常组（60例）抗-HBs浓度对数值的差异及维生素A浓度与抗-HBs浓度对数值的关系。结果当地维生素A摄入量只有19．7％的婴儿达到RNI的80％;维生素A营养不良发生率为67．2％;乙型肝炎抗体平均几何浓度是402．8U／L,阳性率为98．0％,亚临床维生素A缺乏组、可疑亚临床维生素A缺乏组及正常组之间抗-HBs浓度对数值,差异有统计学意义（F=15．88,P〈0．001）,血清维生素A浓度与抗-HBs浓度对数值的相关系数为0．441（P=0．01）。结论血清维生素A可能与抗-HBs抗体有效保护水平的维持有一定关系。     

维生素A、D、E水平与儿童呼吸道感染的相关性研究

目的研究维生素A、D、E水平与儿童呼吸道感染的相关性。方法选取我院呼吸道感染患儿1000例为研究对象,反复呼吸道感染(RRTI)患儿380例为RRTI组,非RRTI患儿620例为非RRTI组,另选同期健康体检儿童300例为对照组。比较三组维生素A、D、E水平、感染指标[血清C反应蛋白(CRP)、血清血红蛋白(Hb)、白细胞计数(WBC)]水平,并分析RRTI患儿维生素A、D、E水平与血清CRP、Hb、WBC水平相关性。结果三组维生素A、D水平相比,差异有统计学意义(P0.05);RRTI组维生素A、D水平低于非RRTI组、对照组(P0.05);三组血清CRP、Hb、WBC水平比较,差异有统计学意义(P0.05);RRTI组血清CRP、WBC水平高于非RRTI组、对照组,血清Hb水平低于非RRTI组、对照组(P0.05);RRTI组治疗后维生素A、D水平高于治疗前,血清CRP、WBC水平低于治疗前,血清Hb水平高于治疗前(P0.05);经Pearson相关性分析,RRTI患儿维生素A、D水平与其血清CRP、WBC水平呈负相关(P0.05),与血清Hb呈正相关(P0.05)。结论 RRTI患儿中维生素A、D水平呈现异常下降状态,与血清CRP、WBC水平呈负相关,与血清Hb呈正相关,有助于判断病情程度,可采取适量补充维生素及膳食治疗措施,以促进病情转归。     

乌鲁木齐、伊宁、阿图什318名维吾尔族孕妇膳食结构调查

目的:了解维吾尔孕妇膳食营养素摄入水平的食物种类,以利于提出孕妇及胎儿健康生长发育的合理膳食建议。方法:于2004-03/2005-05随机调查乌鲁木齐、伊宁、阿图什当地医院门诊就诊的维吾尔族孕妇318名,年龄22～30岁,孕早期组(1～12周)113名、孕中期组(13～27周)104名、孕晚期组(28周～产前)101名。3组孕妇在胎次、职业、烟酒嗜好、生活水平条件上比例均衡,且无口服避孕药史及叶酸服用史,无慢性疾病,无妊娠并发症。采用24h回顾法进行膳食营养状况调查,记录24h进食量,结果采用营养计算器软件V1.6(以国内最新版的“中国食物成分表2002”为基础数据库)计算,计算出平均每人每日食物消耗量和各种营养素摄入量,并与国内修订的《每日膳食中营养素供给量》标准进行比较分析。主要观察膳食构成、热能和各营养素的摄入量、孕妇三大产热营养素的供热比、蛋白质的来源及分布、维生素和矿物质营养情况。结果:纳入对象318名,均进入结果分析。①孕妇的膳食构成中粮谷类占摄入量的35.03%,动物性食品占9.01%,蔬菜、水果分别占11.17%和32.30%,蛋类及乳制品摄入量明显缺乏,仅为1.61%和9.50%。从中国营养学会提出的居民平衡膳食宝塔考虑,需要增加蛋类、奶类、鱼类的摄入量,食物多样化,从而达到平衡营养的需要。②蛋白质的供热比为13.28%,比推荐标准(10%～12%)偏高,碳水化合物的供热比为67.71%,比推荐标准(60%～65%)偏高;脂肪供能比为19.01%,比推荐标准(20%～25%)偏低。③钙的摄入量偏低,为357mg,仅占供给量标准的30%,铁的摄入量偏低,为21mg,仅占供给量标准的60%,而钠、硒、铜、锰的摄入量严重超标分别为3204,78,2.7,6.2mg,分别占供给量标准的212%,156%,135%,177%。同时抗坏血酸(维生素C)摄入一般,达供给量标准的60%。视黄醇、硫胺素(维生素B1)的摄入量分别达供给量标准的97%和79%,但核黄素(维生素B2)摄入偏低,为供给量标准的52%,维生素E的摄入量过高,达供给量标准156%。结论:孕妇膳食中三大营养素分配比例不合理,营养素摄入量普遍不足,孕妇偏食现象严重,维生素A、维生素C、维生素B1、维生素B2易缺乏。     

常见维生素类药物中毒

1　维生素A1 .1　概述　维生素A(vitaminA ,维生素甲 ,视黄醇 ,甲种维生素 )口服极易吸收 ,吸收后贮存于肝脏中 ,几乎全部在体内代谢分解 ,并由尿及粪便排出。用于维生素A缺乏症和需要补充维生素A的儿童、孕妇。1 .2　诊断要点　成人 1次剂量超过 1 0 0万单位 ,小儿 1次超过 3 0万单位 ,即可致急性中毒。急性中毒的表现为 :①剧烈头痛、头晕、精神迟钝 ,婴儿可有前囟膨隆及颅内压增高等。②食欲不振、恶心、呕吐、口渴、腹痛 ,肝肿大且有压痛。③皮肤潮红、奇痒、毛发干枯、脱发、口唇皲裂 ,中毒 1～ 3天后可有不同程度的脱皮等。1 .3　处…     

个性化膳食指导对孕妇维生素A摄入量的影响

[目的]了解孕妇维生素A摄入现状,探讨个性化的饮食指导对孕妇维生素A摄入量的影响。[方法]选择参加孕期营养跟踪的孕妇108例,分别在营养指导前、后进行连续5d膳食称重记录并填写膳食调查表,将膳食调查数据输入计算机营养分析软件（孕妇版）。[结果]指导前孕妇维生素A摄入量的差异性较大,维生素A摄入量未达到预防维生素A缺乏最低标准的占48．15％;超过预防维生素A缺乏最低标准但未达到适宜供给量的占22．22％;达到适宜供给量的占11．11％;超过适宜供给量但未达到可耐受最高摄入量的占12．96％;超过可耐受最高摄入量的占5。56％。指导后孕妇维生素A的摄入量基本达到适宜摄入量。个性化膳食指导前孕妇维生素A的摄入量差异性较大．摄入量不足的比例较高,个性化膳食指导后与指导前相比差异具有统计学意义（P〈0．05）。[结论]孕妇进行个性化膳食指导后维生素A的摄入量基本接近营养推荐量,维生素A的适量摄入有利于孕妇健康及胎儿的生长发育,对孕妇进行维生素A相关知识指导的孕期保健措施值得推广。     

A possible correlation between vitamin D deficiency and loss of smell: 2 case reports

OBJECTIVE: The purpose of this report is to present 2 cases of diminished olfaction that improved with increasing serum levels of vitamin D3. CLINICAL FEATURES: Both patients were under the care of medical and chiropractic physicians for various complaints. A 47-year-old hyposmic woman was diagnosed with vitamin D deficiency who incidentally noticed a progressive return of her sense of smell while taking vitamin D supplements as prescribed by her medical doctor. A 34-year-old anosmic woman noticed a direct relationship with her ability to smell and vitamin D3 supplementation. INTERVENTION AND OUTCOME: Treatment for the first patient consisted of vitamin D supplementation of 10?000 IU a day. Her serum D3 levels increased substantially over a period of 8 months, at which time she reported a marked improvement in her sense of smell. The second patient was prescribed 50?000 IU of vitamin D a week; and she reported an increased ability to smell, although only the strongest of odors. CONCLUSION: A link between hypovitaminosis D and a diminished sense of smell was noted in these 2 individuals.     

Safety and pharmacokinetics of vitamin A therapy for infants with respiratory syncytial virus infections.

Infants with respiratory syncytial virus infection have low serum vitamin A levels. We treated 21 respiratory syncytial virus-infected children with 12,500 to 25,000 IU of oral vitamin A. Vitamin A levels were normalized at 6 h, and none of the children experienced vitamin A toxicity or exacerbation of respiratory illness. Vitamin A treatment of previously healthy respiratory syncytial virus-infected infants at these doses is safe and well tolerated.     

Assessment of vitamin D and calcium status in healthy adult Austrians

BACKGROUND: Because there is reason to assume that also in Austria calcium and vitamin D malnutrition is wide-spread, we initiated a comprehensive study on calcium and vitamin D status in relation to bone health in a large group of the normal adult population. SUBJECTS AND METHODS: We assessed dietary calcium and vitamin D intake, serum concentrations of Ca2+, phosphate, alkaline phosphatase, 25(OH)D, 1,25(OH)2D, parathyroid hormone (PTH), follicle-stimulating hormone (FSH), sex hormones and bone mineral density (BMD) by double-energy X-ray absorptiometry at five different skeletal sites in 648 females and 400 males (age 21-76 years). RESULTS: Mean daily intake of vitamin D (101 IU, range 0.2-320) and calcium (569 mg, range 40-2170) was significantly less than the respective recommended dietary allowances. Two hundred and seventy-one (26%) individuals had hypovitaminosis D with serum 25(OH)D < 12 ng mL(-1), while serum Ca2+ was less than normal in 82 (7.8%) subjects. Multiple regression analysis revealed significant correlations between mean calcium intake and BMD in the femoral region in the men (r = 0.13, P < 0.05) though not in the women. No consistent data could be obtained for associations between BMD and vitamin D status, except for 25(OH)D and BMD at the spine in the men (r = 0.10, P < 0.05). 25(OH)D correlated negatively (P < 0.05) with age in the women (r = -0.11) and with PTH in the women (r = -0.11) and men (r = -0.16). Inversely, a significant (P < 0.001) age-related increase in PTH was observed in both sexes (men, r = 0.19; women, r = 0.14). CONCLUSIONS: Prevalence of hypovitaminosis D in adult Austrians is an imminent risk for development of secondary hyperparathyroidism with advancing age, and requires timely correction of nutritional deficits.     

The interaction of zinc and vitamin A in human schistosomiasis

Levels of vitamin A and components of its transport protein complex, retinol binding protein and prealbumin, as well as zinc and its major binding proteins albumin and alpha 2-macroglobulin were measured in plasma of ninety-one male Egyptian patients with active schistosomal infection and thirty-two healthy adult males. Patients were divided into four groups: Group I had active schistosomiasis without associated complications; Group II had schistosomiasis complicated by colonic polyposis; Group III had advanced schistosomiasis, hepatosplenomegaly and/or ascites; and Group IV had chronic salmonella septicaemia in addition to schistosomiasis. Results showed that all patient groups had subnormal levels of plasma vitamin A, retinol binding protein, prealbumin, zinc and albumin (P less than 0.005 for all parameters) but elevated alpha 2-macroglobulin (P less than 0.001) when compared to the control group. Alterations in the vitamin A transport proteins increased with schistosomal complications and were closely correlated to changes in vitamin A (P less than 0.005), but alterations of albumin and alpha 2-macroglobulin were less consistent and did not correlate with changes in zinc levels. There was a highly significant correlation, however, between plasma zinc concentrations and those of vitamin A, retinol binding protein and prealbumin (P less than 0.001 for all correlations) in all groups of patients as well as the control group. These findings indicate that the binding and transport proteins of both zinc and vitamin A were adversely affected by schistosomiasis and its various complications. Deficiencies of both zinc and vitamin A seem to be interrelated in this disease and the vitamin A transport system may be largely dependent on zinc status.     

Plasma vitamin A transport and visual dark adaptation in diseases of the intestine and liver

Quantitative analyses of plasma concentrations of retinol binding protein (RBP), prealbumin and total proteins were performed in normal subjects and in forty-two patients suffering from diseases of the intestine and liver. The visual dark adaptation ability (DAA) was also assessed. Reduction of DAA and of RBP and prealbumin levels was noted in patients with chronic liver disease and fat malabsorption. In sixty-eight patients with intestinal diseases the RBP concentration seemed to be reduced in relation to the degree and duration of steatorrhoea. Furthermore, inflammatory activity, as revealed by laborabory tests, markedly reduced the RBP level. Treatment with vitamin A increased the RBP and prealbumin concentrations and restored the DAA to normal in patients with malabsorption but normal liver function. In patients with liver disease reduced DAA and serum RBP values were not affected by vitamin A therapy. Only at RBP concentrations below half the normal was impairment of the dark adaptation observed, suggesting that serum RBP is a more sensitive indicator of vitamin A deficiency than measurement of dark adaptation.     

儿童社区获得性肺炎血清维生素A的变化及与免疫功能相关性

目的 研究社区获得性肺炎(community acquired pneumonia, CAP)患儿血清维生素A(vitamin A,VA)水平及与免疫功能的相关性,为肺炎病情评估提供一定参考。方法 以入住新乡医学院第一附属医院PICU的63例重度社区获得性肺炎(severe community acquired pneumonia, SCAP)患儿(SCAP组)、普通儿科病区的30例轻度社区获得性肺炎(mild community acquired pneumonia, MCAP)患儿(MCAP组),以及同期体检的30名健康儿童(对照组)为研究对象,检测其血清中VA和免疫球蛋白(immunoglobulin, Ig)G、IgA、IgM水平,及SCAP组体内T淋巴细胞亚群(总T淋巴细胞、CD4、CD8、CD4/CD8),并对SCAP组体内VA水平及以上指标的相关性进行分析。结果 3组性别和年龄差异无统计学意义;血清中VA的平均含量分别为0.36、0.25和0.19 mg/L,CAP组VA的含量较对照组明显降低,且SCAP组明显低于MCAP组(P<0.05)。根据WHO推荐的VA诊断...     

铜川地区1400例0～6岁儿童维生素A、E水平分析

目的分析铜川地区1400例0~6岁儿童维生素A、E水平。方法收集2018年1月1日至2018年12月31日在我院健康体检的1400例0~6岁儿童的临床资料,采用液相串联质谱法测定血浆维生素A、E水平。分析不同年龄儿童的维生素A、E缺乏情况;比较不同年龄段、性别儿童的维生素A、E水平。结果铜川地区1400例0~6岁儿童维生素A平均水平为(0.29±0.08)mg/L,总体缺乏率为49.86%;0~6岁儿童维生素E平均水平为(9.87±2.85)mg/L,总体缺乏率为1.29%。相同性别不同年龄段儿童的血浆维生素A、E水平差异显著(P<0.05)。>1~3岁男童的血浆维生素E水平低于>1~3岁女童,差异具有统计学意义(P<0.05)。结论本地区0~6岁儿童维生素A营养状况不容乐观,维生素E营养状况尚可,临床医生应加强0~6岁儿童维生素A的定期检测与补充。     

Effect of vitamin D3 supplementation on the pharmacokinetics of digoxin--a pilot study

Emerging evidence from preclinical, clinical and epidemiological studies suggests that vitamin D3 plays vital roles in several diseases in addition to bone disorders. According to new medical evidence, it is being recommended that vitamin D3 intake to be increased for maximal benefits in human health. However, it is necessary to consider potential side effects of increased intake of vitamin D3. Vitamin D3 exerts its actions through the vitamin D receptor, which is known to be an important regulator of P-glycoprotein (P-gp). As P-gp plays a significant role in limiting drug bioavailability, we undertook a study to compare single-dose digoxin (a P-gp substrate) pharmacokinetics in eight healthy male subjects before and after vitamin D3 supplementation (1000 IU per day). The geometric mean ratios for AUC(0-3h), AUC(0-48h) and C(max) were 1.06 (90% CI 0.92, 1.21) and 1.02 (90% CI 0.97, 1.08) and 1.03 (95% CI 0.86, 1.24), respectively. The median for digoxin T(max) was 0.75 h before and after vitamin D3 ingestion. The mean plasma 25-hydroxyvitamin D3 (25(OH)D3) levels remained constant after the intake of vitamin D3 (15.4 ± 3.7 and 14.4 ± 3.6 ng/mL, respectively), while there was a modest but statistically significant increase in plasma calcium levels, from 9.32-9.68 mg/dL (P = 0.0277). These results suggest that vitamin D3 supplementation (1000 IU per day) in human volunteers does not produce a P-gp-mediated drug interaction with orally administered digoxin.     

维生素AD联合铁剂治疗婴幼儿缺铁性贫血的效果

目的:观察维生素AD滴剂联合蛋白琥珀酸铁口服液治疗婴幼儿缺铁性贫血的临床效果。方法:选取安徽省庐江县人民医院儿童保健门诊缺铁性贫血患儿102例,性别不限,采用随机数字表法分为观察组(n=52)和对照组(n=50)。观察组治疗采用蛋白琥珀酸铁口服液联合维生素AD滴剂口服,对照组治疗仅采用蛋白琥珀酸铁口服液口服。治疗前分析缺铁性贫血患儿维生素A和25-羟维生素D缺乏情况,于治疗1个月后对2组治疗效果进行比较并对贫血相关指标进行分析。结果:治疗前两组缺铁性贫血患儿维生素A和25-羟维生素D缺乏严重。治疗后,观察组的显效率为61.54%,明显高于对照组的44%(P<0.05);总有效率为94.23%,也明显高于对照组的84%(P<0.05);观察组血红蛋白、血清铁和血清铁蛋白较对照组明显改善(P<0.05)。结论:维生素AD滴剂联合蛋白琥珀酸铁口服液用于婴幼儿缺铁性贫血治疗时可有效改善患儿相关的贫血指标,显著提高临床治疗效果。