Semba R D, Wirasasmita S, Natadisastra G, Sommer A
Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute and School of Public Health, Johns Hopkins University, Baltimore, MD 21205.
Am J Ophthalmol. 1990 Oct 15;110(4):416-20. doi: 10.1016/s0002-9394(14)77024-2.
In a double-masked, placebo-controlled, clinical trial in Indonesia, 88 preschool children between the ages of 36 and 72 months with Bitot's spots were randomly assigned to 200,000 IU of oral vitamin A or placebo and followed up for five weeks. Baseline and follow-up serum vitamin A levels were obtained. Of the 45 children receiving vitamin A, 33 (73.3%) showed complete cure and disappearance of Bitot's spots, six (13.3%) had disappearance of some but not all Bitot's spots, and six (13.3%) were unresponsive to treatment. The nonresponsive children were older, all male, and had higher initial mean serum vitamin A levels, 23.0 micrograms/dl, compared to 15.9 micrograms/dl in the cured group (P = .017). These data suggest that normal vitamin A status may be found in approximately 13% of children with Bitot's spots before vitamin A intervention and that one fourth of those who had Bitot's spots originally will not be cured of all Bitot's spots after intervention. These are important factors to consider when using Bitot's spots in prevalence surveys as a clinical sign of vitamin A deficiency.
在印度尼西亚进行的一项双盲、安慰剂对照临床试验中，88名年龄在36至72个月之间患有毕脱斑的学龄前儿童被随机分为两组，分别给予20万国际单位的口服维生素A或安慰剂，并随访5周。测定了基线和随访时的血清维生素A水平。在接受维生素A治疗的45名儿童中，33名（73.3%）毕脱斑完全治愈并消失，6名（13.3%）部分毕脱斑消失但未完全消失，6名（13.3%）对治疗无反应。无反应的儿童年龄较大，均为男性，初始平均血清维生素A水平较高，为23.0微克/分升，而治愈组为15.9微克/分升（P = 0.017）。这些数据表明，在维生素A干预前，约13%患有毕脱斑的儿童维生素A状态可能正常，且最初患有毕脱斑的儿童中有四分之一在干预后毕脱斑不会完全治愈。在将毕脱斑作为维生素A缺乏的临床体征用于患病率调查时，这些是需要考虑的重要因素。
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