Efficacy of a single oral dose of 200,000 IU of oil-soluble vitamin A in measles-associated morbidity.
Efficacy of a single oral dose of 200,000 IU of oil-soluble vitamin A in measles-associated morbidity.
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单次口服 200,000 IU 油溶性维生素 A 对麻疹相关发病的疗效。
DOI：
10.1093/oxfordjournals.aje.a008761
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发表时间：
1996
影响因子：
5
通讯作者：
Steven D. Goodman
中科院分区：
文献类型：
--
作者：
F. Rosales;C. Kjolhede;Steven D. Goodman
作者评估了世界卫生组织（WHO）推荐的200，000 IU维生素A油治疗急性非干眼性麻疹患者的有效性。1991年，在赞比亚的恩多拉进行了一项维生素A（n=90）与安慰剂（n=110）的随机、双盲、临床试验，对不需要住院治疗的急性麻疹患者进行了登记。麻疹相关的发病率定义为是否存在急性呼吸道感染的体征和症状。前3天的每日评估之后，每周访问城市卫生中心一个月。两组的基线人口统计学、临床和生化特征相似。在每次每周评估时，按组对发病状态进行的横断面分析显示，直到第4周才出现显著差异，此时安慰剂治疗患者出现咳嗽或肺炎的比例更高（p=0.005）。然而，纵向分析研究了个体之间的变化并控制了初始健康状况，结果更加模棱两可。维生素A治疗受试者中麻疹咳嗽患者发生肺炎的比值比为0.73（95%置信区间（CI）0.30-1.80）。无症状麻疹患者发生麻疹相关咳嗽或肺炎的比值比为0.52（95%CI 0.24-1.13），有利于维生素A，但维生素A治疗受试者肺炎未能改善的比值比为1.23（95%CI 0.68-2.3），有利于安慰剂。这些结果表明，一剂油中维生素A预防麻疹并发症的有效性的证据不如先前两剂200，000 IU水溶性维生素A所显示的那样强，并且世卫组织的建议可能需要重新审查。
The authors assessed the efficacy of the World Health Organization (WHO) recommendation of 200,000 IU of vitamin A in oil to treat acute non-xerophthalmic measles patients. Acute measles patients who did not require hospitalization were enrolled in a randomized, double-masked, clinical trial of vitamin A (n=90) versus placebo (n=110) carried out in Ndola, Zambia, in 1991. Measles-associated morbidity was defined by the presence of signs and symptoms of acute respiratory infection. Daily evaluations for the first 3 days were followed by weekly visits for a month at urban health centers. Baseline demographic, clinical, and biochemical characteristics were similar in both groups. Cross-sectional analysis of morbidity status, by group, at each weekly evaluation showed no significant differences until week 4, when more placebo-treated patients had cough or pneumonia (p=0.005). However, longitudinal analysis, which looked at changes among individuals and controlled for initial health status, showed more equivocal results. The odds ratio for the development of pneumonia in patients with measles cough in vitamin A-treated subjects was 0.73 (95% confidence interval (Cl) 0.30-1.80). The odds ratio for the development of measles-associated cough or pneumonia in asymptomatic measles patients was 0.52 (95% Cl 0.24-1.13), in favor of vitamin A, but the odds ratio for failing to improve from pneumonia in vitamin A-treated subjects was 1.23 (95% Cl 0.68-2.3), a result in favor of placebo. These results suggest that the evidence for the efficacy of one dose of vitamin A in oil to prevent measles complications is not as strong as that previously shown for two 200,000 IU doses of water-miscible vitamin A, and that the WHO recommendation may need to be reexamined.