Arnold J D, Leslie G I, Earl J W, O'Halloran M
Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Aust Paediatr J. 1989 Jun;25(3):168-70. doi: 10.1111/j.1440-1754.1989.tb01444.x.
The distribution of plasma Vitamin E (VE) was determined in 25 very low birthweight (VLBW) infants who were supplemented with 100 mg/kg per day of alpha-tocopherol acetate, given intragastrically. Their mean birthweight was 917 g and mean gestational age was 28 weeks. Mean plasma VE levels after 1 and 6 weeks' supplementation were 2.7 mg/dL (s.e.m. = 1.0) and 6.4 mg/dL (s.e.m. = 1.4), respectively (the difference was not significant). There was wide variability in plasma VE levels in these infants despite being on an identical dose of tocopherol. Plasma VE was less than 0.5 mg/dL in 12% of samples, 0.5-3.0 mg/dL in 32%, 3.1-5.0 mg/dL in 18%, and 5.1-20 mg/dL in 38%. Fifteen of the 25 infants had at least one level in the range which has been associated with an increased incidence of septicaemia and necrotizing enterocolitis (greater than 5.0 mg/dL). These data suggest that if a policy of VE supplementation for VLBW infants is chosen, monitoring of plasma VE levels appears necessary so that the dosage can be adjusted in order to maintain plasma VE within the optimal range. This study's dosage regimen of supplementing infants with 100 mg/kg per day of VE was associated with a high incidence of elevated plasma VE levels and it is concluded that it is not advisable to use such large doses of VE in the premature newborn.
对25名极低出生体重（VLBW）婴儿进行了血浆维生素E（VE）分布的测定，这些婴儿每天经胃内给予100mg/kg的醋酸生育酚。他们的平均出生体重为917g，平均胎龄为28周。补充1周和6周后的平均血浆VE水平分别为2.7mg/dL（标准误=1.0）和6.4mg/dL（标准误=1.4）（差异不显著）。尽管给予相同剂量的生育酚，但这些婴儿的血浆VE水平仍存在很大差异。12%的样本中血浆VE低于0.5mg/dL，32%在0.5 - 3.0mg/dL之间，18%在3.1 - 5.0mg/dL之间，38%在5.1 - 20mg/dL之间。25名婴儿中有15名至少有一次血浆VE水平处于与败血症和坏死性小肠结肠炎发病率增加相关的范围内（大于5.0mg/dL）。这些数据表明，如果选择对VLBW婴儿补充VE的策略，监测血浆VE水平似乎是必要的，以便调整剂量以将血浆VE维持在最佳范围内。本研究中每天给婴儿补充100mg/kg VE的剂量方案与血浆VE水平升高的高发生率相关，得出的结论是，对早产新生儿使用如此大剂量的VE是不可取的。
