肺炎和腹泻患儿维生素A状况的分析

【目的】　探讨肺炎、腹泻患儿的维生素A(VA)状况并对其进行分析。　【方法】　用血清VA值评价 60例肺炎、85例腹泻患儿和 10 0名健康儿童的血清VA状况。用相对剂量反应 (RDR)深入研究患儿体内VA状况并对其进行多元回归分析。以血清VA <0 .7μmol/L ,RDR≥ 2 0 %为亚临床VA缺乏 (SVAD)诊断标准。 　【结果】　肺炎、腹泻患儿的血清VA值分别为 (1.0± 0 .4) μmol/L、(0 .7± 0 .4) μmol/L ,明显低于健康儿童 (1.9± 0 .6) μmol/L(P <0 .0 1)。肺炎、腹泻患儿的RDR均值分别为 2 3 %± 2 0 % ,2 3 %± 13 % ,SVAD检出率分别为 43 .3 %和 61.2 % (P <0 .0 5 )。肺炎患儿的RDR值和SVAD检出率以小年龄农村、发热组为高 (P <0 .0 5 )。腹泻患儿的RDR值和SVAD检出率以小年龄、脱水组为高 (P <0 .0 1)。多元回归分析提示 :家居农村发热是肺炎患儿 ,小年龄、热度高、脱水是腹泻患儿SVAD的影响因素。　【结论】　肺炎、腹泻患儿的血清VA状况劣于健康儿童。年龄小、家居农村、发热和脱水与其体内VA状况关系较密切

A Study on Vitamin A Status among Children with Pneumonia and Diarrhea.

【Objective】　To explore the body vitamin A(VA) status among children with pneumonia or diarrhea and its risk factors.　【Methods】　Vitamin A status and risk factors are identified by measured the concentration of serum vitamin A and Relative Dose Response(RDR).60 children with pneumonia,85 children with diarrhea and 100 health children were investigated.RDR≥20% or serum VA＜0.70umol is considered as Subclinical Vitamin A Deficiency(SVAD).　【Results】　The result showed that serum VA levels of the cases with pneumonia,diarrhea and health children were(1.0±0.4) umol/L,(0.7±0.4)umol/L and (1.9±0.6)umol/L respectively (F=152.890,P＜0.01).The incidences of SVAD in 3 groups were 28.3%,54.1% and 1.0%,respectively (χ2＝67.381,P＜0.005).Among children with pneumonia and diarrhea,the average values for RDR are 23%±20% and 23%±13%,respectively.The incidence of SVAD among children with diarrhea (61.2%) was significantly higher than those with pneumonia(43.3%)(P＜0.05).Children with diarrhea who were younger,high fever,dehydration had markedly higher RDR and incidence of SVAD(P＜0.01).Among children with pneumonia,those in rural area and fever had higher RDR than their control group(P＜0.05).　【Conclusions】　The incidence of SVAD among children with pneumonia and diarrhea was higher than that in health children.Among children with pneumonia and diarrhea,multiple risk factors needs to be considered together for SVAD.Overall,children who were younger,in rural area,with symptoms such as fever,dehydration,were more susceptible for SVAD.