Vitamin A levels and mortality among hospitalized measles patients, Kinshasa, Zaire.
Vitamin A levels and mortality among hospitalized measles patients, Kinshasa, Zaire.
复制标题
金沙萨、扎伊尔住院麻疹患者的维生素 A 水平和死亡率。
DOI：
10.1093/tropej/35.3.109
复制
发表时间：
1989
影响因子：
2
通讯作者：
R. Ryder
中科院分区：
文献类型：
--
作者：
L. Markowitz;N. Nzilambi;W. J. Driskell;M. Sension;E. Rovira;P. Nieburg;R. Ryder
最近，在维生素A缺乏是公认问题的社区，建议对麻疹儿童进行大剂量维生素A治疗。然而，维生素A与麻疹死亡率之间的关系尚未明确确定。我们研究了1987年1月至3月在扎伊尔金沙萨的Yemo和Kalembe医院住院的283名5岁以下儿童的血清维生素A水平。用高效液相色谱法测定维生素A水平。维生素A水平从不到5微克/分升到63微克/分升(中位数为8)。总病死率为26%。在单变量分析中，年龄不到24个月、入院时肺炎、淋巴细胞减少(低于2000/mm3)和较低的维生素A水平与住院期间的死亡相关。在多变量Logistic回归模型中，维生素A水平低于5微克/分升与24个月以下儿童的死亡结局相关(相对风险=2.9，95%可信区间1.3，6.8)，但与年龄较大的儿童无关。需要进一步研究，以确定低维生素A水平是否使儿童易患严重麻疹，以及维生素A补充剂在预防麻疹死亡率方面的作用。
Treatment with high dose vitamin A has recently been recommended for children with measles in communities where vitamin A deficiency is a recognized problem. However, the relationship between vitamin A and measles mortality has not been clearly established. We studied serum vitamin A levels in 283 children less than or equal to 5 years of age admitted to Mama Yemo and Kalembe Lembe Hospitals in Kinshasa, Zaire, between January and March, 1987. Vitamin A levels were determined by high performance liquid chromatography. Vitamin A levels ranged from less than 5 to 63 micrograms/dl (median, 8). The overall case-fatality rate was 26 per cent. On univariate analysis, age less than 24 months, pneumonia on admission, lymphopenia (less than 2000/mm3), and lower vitamin A levels were associated with death during hospitalization. In a multivariate logistic regression model, a vitamin A level less than 5 micrograms/dl was associated with fatal outcome for children younger than 24 months old (relative risk = 2.9, 95 per cent CI 1.3, 6.8), but not for older children. Further studies are needed to determine whether low vitamin A levels predispose children to severe measles and the role of vitamin A supplements in the prevention of measles mortality.