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目的评价早产儿基础维生素A营养状况、与疾病的关系及常规补充的效果。方法高效液相色谱法检测2006年1月至2007年2月北京大学第一医院出生24h内的早产儿(147名)血浆视黄醇浓度,足月儿(40名)脐血作为对照。根据临床治疗常规,早产儿静脉(1650U/d)和(或)口服(750U/d)补充维生素A,随访早产儿血浆视黄醇浓度。结果出生时,早产儿血浆视黄醇浓度低于足月儿,差异有统计学意义,分别为(0.161±0.051)μg/mL和(0.187±0.055)μg/mL(P=0.005)。早产儿维生素A缺乏(VAD)发生率高于足月儿,但差异无统计学意义。多元线性回归分析显示出生体重与血浆视黄醇浓度呈正相关。31例早产儿补充维生素A2周后,随访血浆视黄醇浓度显著升高,分别为(0.168±0.046)μg/mL和(0.203±0.063)μg/mL(P=0.014);VAD发生率显著下降,分别为100%和48%(P<0.001)。未发现补充剂量、方式对随访维生素A浓度的影响,未发现出生时血浆视黄醇浓度与新生儿期疾病的关系。结论早产儿基础维生素A营养状况不良,常规补充可在一定程度上改善2周时维生素A营养状况。
Objective To evaluate the nutritional status of basic vitamin A in preterm infants, the relationship with the disease and the effect of routine supplement. Methods The plasma retinol concentrations of preterm infants (147) and full term infants (40) were detected within 24 hours of birth from January 2006 to February 2007 in Peking University First Hospital as controls. According to clinical treatment routine, intravenous (1650U / d) and / or oral (750U / d) vitamin A in preterm infants were followed up for plasma retinol concentrations in preterm infants. Results At birth, plasma retinol concentrations in preterm infants were lower than those in term infants, with significant differences (0.161 ± 0.051) μg / mL and (0.187 ± 0.055) μg / mL, respectively (P = 0.005). The incidence of vitamin A deficiency (VAD) in preterm infants was higher than that in term infants, but the difference was not statistically significant. Multivariate linear regression analysis showed that birth weight was positively correlated with plasma retinol concentration. After 31 weeks of vitamin supplementation in preterm infants, the follow-up plasma retinol concentrations were significantly higher at follow-up (0.168 ± 0.046 μg / mL and 0.203 ± 0.063 μg / mL, respectively; P = 0.014) , Respectively, 100% and 48% (P <0.001). Did not find the dose of supplement, the way of follow-up of vitamin A concentration, did not find the relationship between plasma retinol concentration and neonatal disease. Conclusion The nutritional status of basal vitamin A in preterm infants is not good, and routine supplementation can improve the nutritional status of vitamin A at 2 weeks.