Landman J, Sive A, Heese H D, Van der Elst C, Sacks R
Department of Paediatrics and Child Health, University of Cape Town, South Africa.
Early Hum Dev. 1992 Sep;30(2):163-70. doi: 10.1016/0378-3782(92)90143-5.
Vitamin A deficiency associated with preterm delivery is not readily reversible using the recommended supplement of 1500 IU per day. It has been reported that 2000 IU of intramuscular vitamin A administered on alternate days for 28 days will correct the deficiency. The objective of this study was to compare this regime with the practice in our nursery of giving 5000 IU of vitamin A per day with the early introduction of feeds. The vitamin A status of ten preterm infants (mean gestation 30.5 weeks) who received intramuscular vitamin supplementation was compared with that of nine infants (mean gestation 30.7 weeks) given enteral vitamin A. Vitamin A status was evaluated on the 32nd day of life using plasma retinol and retinol-binding protein (RBP) concentrations and a modified relative dose response (RDR) test. Plasma retinol and RBP concentrations were similar in the two groups shortly after birth revealing vitamin A deficiency. By the 32nd day of life, plasma retinol and RBP concentrations had risen significantly in both groups and in 70% the modified RDR was normal. Differences between the groups were not observed irrespective of the method of vitamin A administration. None of the infants developed clinical or biochemical vitamin A toxicity. In most preterm infants who tolerate feeds, vitamin A deficiency can be corrected safely by supplementing the feeds with 5000 IU of vitamin A per day.
与早产相关的维生素A缺乏症，使用每天1500国际单位的推荐补充剂量难以迅速逆转。据报道，每隔一天肌肉注射2000国际单位维生素A，持续28天可纠正这种缺乏症。本研究的目的是将这种方案与我们托儿所早期喂养时每天给予5000国际单位维生素A的做法进行比较。将10名接受肌肉注射维生素补充的早产儿（平均孕周30.5周）的维生素A状况与9名接受肠内维生素A的婴儿（平均孕周30.7周）的状况进行比较。在出生第32天时，使用血浆视黄醇、视黄醇结合蛋白（RBP）浓度和改良相对剂量反应（RDR）试验评估维生素A状况。两组出生后不久血浆视黄醇和RBP浓度相似，均显示维生素A缺乏。到出生第32天时，两组血浆视黄醇和RBP浓度均显著升高，70%的婴儿改良RDR正常。无论维生素A的给药方法如何，两组之间均未观察到差异。没有婴儿出现临床或生化维生素A中毒。对于大多数能耐受喂养的早产儿，每天在喂养中补充5000国际单位维生素A可安全纠正维生素A缺乏。
