Vitamin A megadoses during early infancy on serum retinol concentration and acute side effects and residual effects on 6 month follow-up
Vitamin A megadoses during early infancy on serum retinol concentration and acute side effects and residual effects on 6 month follow-up
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DOI：
10.1016/s0271-5317(97)00035-3
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发表时间：
1997-04-01
影响因子：
4.5
通讯作者：
Habte, D
中科院分区：
文献类型：
--
作者：
Mahalanabis, D;Rahman, MM;Habte, D
在一项随机双盲对照试验中，我们评估了来自孟加拉国贫困城市6至17周的主要母乳喂养的婴儿每月口服3剂50,000 IU维生素A以及百白破和口服脊髓灰质炎疫苗的安全性和有效性。97名婴儿服用维生素A， 103名服用安慰剂。大多数婴儿的初始空腹血清视黄醇浓度非常低（52% < 10 μ g/dl, 74% < 15 μ g/dl），两组均有所改善，但30%接受维生素A的婴儿仍低于15 μ g/dl，维生素A组中有9名婴儿和安慰剂组中有2名婴儿在第二次和/或第三次剂量后fontanelle肿胀（RR = 4.78, 95% CI 1.06-21.54, P < 0.025），并在48小时内消退。综上所述，孟加拉国贫困城市社区的婴儿缺乏维生素a；即使在服用了三次大剂量的维生素a之后，仍有很大比例的婴儿缺乏维生素a。尽管缺乏维生素a，但9.3%的婴儿在服用这种剂量表的维生素a时出现了明显的毒性表现——囟门凸起。Elsevier Science Inc.版权所有
We evaluated the safety and efficacy of 3 oral doses of 50,000 IU vitamin A at monthly intervals in predominantly breastfed infants from poor urban Bangladesh aged 6 to 17 weeks along with DPT and oral polio vaccines in a randomised double-masked controlled trial. Ninety-seven infants received vitamin A and 103 received placebo. Initial fasting serum retinol concentrations were very low in most infants (52% < 10 mu g/dl and 74% < 15 mu g/dl) which improved in both groups but was still less than 15 mu g/dl in 30% of those who received vitamin A. Nine infants in the vitamin A group and 2 in the placebo group had bulged fontanelle after the second and/or third dose (RR = 4.78, 95% CI 1.06-21.54, P < 0.025) which resolved in 48 hours. In conclusion young infants from a deprived urban community in Bangladesh were deficient in vitamin A; a large proportion remained deficient even after three large doses of vitamin A. In spite of deficiency, bulged fontanelle, an apparent toxic manifestation, occurred in 9.3% with this dosage schedule of vitamin A. Alternative and/or complementary approaches e.g. maternal supplementation are needed to prevent vitamin A deficiency in under 6 month infants in developing countries. Copyright (C) 1997 Elsevier Science Inc.