Sovani I, Humphrey J H, Kuntinalibronto D R, Natadisastra G, Tielsch J M
Cicendo Eye Hospital, Bandung, Indonesia.
Am J Ophthalmol. 1994 Dec 15;118(6):792-6. doi: 10.1016/s0002-9394(14)72560-7.
A randomized, controlled clinical trial was conducted in Indonesia to study the response of Bitot's spots to a 100,000-IU dose of vitamin A, which is known to be associated with fewer acute side effects than the currently recommended 200,000-IU dose.
A total of 114 children (ages 13 to 59 months) with Bitot's spots were given an ocular examination; serum retinol concentration was measured, and the relative dose response test carried out. After administering one 100,000- or 200,000-IU oral dose of vitamin A, ocular examinations were repeated weekly for seven weeks and then biweekly for 20 more weeks, or until lesions were healed on two consecutive examinations.
Either dose of vitamin A was similarly effective in healing Bitot's spots. The most important factor in predicting responsiveness to treatment was baseline serum retinol concentration: children with lower pretreatment concentrations were more likely to have responsive lesions. No child had a relapse within the first three months after treatment. However, by six months, children who had received the higher dose were 82% less likely to have a relapse compared with children who had received the lower dose.
Although either a 100,000- or 200,000-IU dose of vitamin A is similarly effective in healing Bitot's spots, a 200,000-IU dose provides longer protection. This benefit justifies the higher rates of transient mild side effects associated with the 200,000-IU dose. The current 200,000-IU dose of vitamin A recommended by the World Health Organization for prophylactic dosing should not be reduced.
在印度尼西亚进行了一项随机对照临床试验，以研究毕脱斑对100,000国际单位剂量维生素A的反应，已知该剂量与目前推荐的200,000国际单位剂量相比，急性副作用更少。
对114名患有毕脱斑的儿童（年龄13至59个月）进行眼部检查；测量血清视黄醇浓度，并进行相对剂量反应试验。口服一剂100,000或200,000国际单位的维生素A后，每周重复进行眼部检查，持续7周，然后每两周重复进行20周，或直到连续两次检查病变愈合。
两种剂量的维生素A在治愈毕脱斑方面同样有效。预测治疗反应性的最重要因素是基线血清视黄醇浓度：治疗前浓度较低的儿童病变更有可能有反应。治疗后的前三个月内没有儿童复发。然而，到六个月时，接受高剂量的儿童复发的可能性比接受低剂量的儿童低82%。
虽然100,000或200,000国际单位剂量的维生素A在治愈毕脱斑方面同样有效，但200,000国际单位剂量能提供更长时间的保护。这种益处证明了与200,000国际单位剂量相关的较高短暂轻度副作用发生率是合理的。世界卫生组织推荐的目前200,000国际单位剂量的维生素A预防性给药不应降低。
