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早产和足月婴儿维生素A补充的叙述性综述

A Narrative Review of Vitamin A Supplementation in Preterm and Term Infants.

作者信息

Kumar Abhishek, Anjankar Ashish

机构信息

Department of Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2022 Oct 12;14(10):e30242. doi: 10.7759/cureus.30242. eCollection 2022 Oct.

Abstract

Vitamin A deficiency is an epidemiologically significant concern in all age groups, especially in preterm and term infants. Its deficiency causes various developmental malformations. Vitamin A supplementation has been a practiced alternative for many decades, but its effectiveness is debatable in the medical system. The bioavailability of beta-carotenes varies greatly and ranges from 2% to 30%, depending on how it is present in the plant's cellular composition. Vitamin A has a bioavailability of up to 75%. The bioavailability of beta-carotenes is positively impacted by several activities but mainly by mechanical ones that allow cellular interaction. These include enough chewing, mincing, and pureeing. The bioavailability of beta-carotene can be increased by moderate cooking and combining high-quality lipids. The WHO recommends waiting for a minimum of one month between vitamin A dosages. Six months is the maximum amount of time between dosages. For instance, giving the optimum dosage to a child who has not had vitamin A in two months is preferable to skipping the dose and making the child wait eight months (i.e., two months plus six months) before receiving the following amount. There were no discernible variations in the occurrence of momentarily increased aspartate aminotransferase (AST), alanine transaminase (ALT), or alkaline phosphatase between the leading group and the trace group. However, patients in the top group experienced high blood triacylglycerol levels more frequently than those in the trace group, suggesting that hypertriacylglycerolemia may be a side effect of vitamin A administration. It is imperative to memo that neonatal vitamin A supplementation negatively affects subsequent diphtheria-pertussis-tetanus (DPT) vaccination in females. Since many children are delayed in obtaining their initial DPT series, several nations prescribe DPT boosters, so older children may be affected if vitamin A supplementation negatively interacts with DPT in such children.

摘要

维生素A缺乏在所有年龄组中都是一个具有流行病学意义的问题,尤其是在早产儿和足月儿中。其缺乏会导致各种发育畸形。几十年来,补充维生素A一直是一种常用的替代方法,但其有效性在医疗系统中存在争议。β-胡萝卜素的生物利用率差异很大,在2%至30%之间,这取决于它在植物细胞组成中的存在方式。维生素A的生物利用率高达75%。β-胡萝卜素的生物利用率受到多种活动的积极影响,但主要是通过允许细胞相互作用的机械活动。这些活动包括充分咀嚼、切碎和打成泥状。适度烹饪并搭配优质脂质可以提高β-胡萝卜素的生物利用率。世界卫生组织建议维生素A剂量之间至少间隔一个月。剂量之间的最长时间为六个月。例如,给一个已经两个月没有补充维生素A的孩子给予最佳剂量,比跳过该剂量并让孩子等待八个月(即两个月加六个月)再接受下一次剂量要好。在高剂量组和低剂量组之间,暂时升高的天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)或碱性磷酸酶的发生率没有明显差异。然而,高剂量组的患者比低剂量组的患者更频繁地出现高血三酰甘油水平,这表明高甘油三酯血症可能是维生素A给药的副作用。必须注意的是,新生儿补充维生素A对女性随后的白喉-百日咳-破伤风(DPT)疫苗接种有负面影响。由于许多儿童在获得初始DPT系列疫苗方面有所延迟,一些国家规定了DPT加强针,因此如果维生素A补充剂与这类儿童的DPT产生负面相互作用,年龄较大的儿童可能会受到影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec15/9650930/9a319e093a8f/cureus-0014-00000030242-i01.jpg

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