ROUTINE HIGH-DOSE VITAMIN-A THERAPY FOR CHILDREN HOSPITALIZED WITH MEASLES
ROUTINE HIGH-DOSE VITAMIN-A THERAPY FOR CHILDREN HOSPITALIZED WITH MEASLES
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DOI：
10.1093/tropej/39.6.342
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发表时间：
1993-12-01
影响因子：
2
通讯作者：
KLEIN, M
中科院分区：
文献类型：
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作者：
HUSSEY, GD;KLEIN, M
麻疹没有特定的治疗方法，仍然是全球儿童死亡的重要原因。在对照研究中，高剂量维生素A治疗（Hi-VAT）-含400 000 IU维生素A-已被证明可显著降低麻疹相关的发病率和死亡率。我们对1720名15岁以下因麻疹住院的儿童的医院记录进行了回顾性研究，以确定这些研究结果在研究环境中适用于常规医院实践条件下麻疹病例管理的程度。结果进行了研究，在两个非连续的2年期间（1985-6年和1989-90年）住院的儿童。在此期间，开始对所有麻疹住院儿童实行高增值税政策。与接受标准治疗的儿童组相比，（n = 1061），接受HI-VAT的儿童（n = 651）的住院时间较短（平均10天对13天; P < 0.001），对重症监护的要求较低（4.3%对10.5%; P < 0.001），死亡率较低（1.6%对5%; P < 0.001）。未观察到HI-VAT治疗的不良反应。我们的结论是，高剂量口服维生素A（400 000 IU）补充麻疹的政策提供的好处，相当于以前只在对照研究试验中观察到的，这是非常具有成本效益的，它应该成为所有麻疹住院儿童的常规病例管理的一部分。
Measles is without specific therapy and remains important globally as a cause of childhood death. In controlled studies, high-dose vitamin A therapy (Hi-VAT)-with 400 000 IU vitamin A-has been demonstrated to markedly reduce measles-associated morbidity and mortality. We performed a retrospective study of the hospital records of 1720 children < 15 years of age who were hospitalized for measles, to determine the extent to which these findings, in research settings, are applicable to the case management of measles under conditions of routine hospital practice. The outcomes were studied of children hospitalized during two non-consecutive 2 year periods (1985-6 and 1989-90). A policy of Hi-VAT for all children hospitalized with measles was started during the intervening period. As compared with the group of children on standard therapy (n = 1061), children receiving HI-VAT (n = 651) had a shorter hospital stay (mean 10 versus 13 days; P < 0.001), a lower requirement for intensive care (4.3 versus 10.5 per cent; P < 0.001), and a lower death rate (1.6 versus 5 per cent; P < 0.001). No adverse effects of HI-VAT therapy were observed. We conclude that a policy of high dose oral vitamin A (400 000 IU) supplementation in measles provides benefits which are equivalent to those previously observed only in controlled research trials, that it is highly cost effective, and that it should form part of the routine case management of all children hospitalized with measles.