Huet F, Semama D, Maingueneau C, Charavel A, Nivelon J L
Service de pédiatrie 1, Hôpital d'enfants, Dijon, France.
Eur J Pediatr. 1997 Dec;156(12):949-51. doi: 10.1007/s004310050749.
The aim of this study was to document plasma retinol status and nocturnal vision in ten eutrophic adolescents with cystic fibrosis (CF) receiving daily retinol supplementation. Plasma retinol, alpha and beta carotenes and retinol binding protein were measured in ten clinically stable CF patients (mean age: 14.3 years; Shwachman score: 80-100). Nocturnal vision evaluation was performed with a Beyne optometer. Plasma retinol (mean 0.42 +/- 0.16 mg/l), alpha carotene and beta carotene levels were below the lower limit of normal in all but one patient. Five out of ten patients with normal standard opthalmological examination presented a poor (n = 3 patients) or a pathological (n = 2) dark adaptation test. These two patients showed a dramatic increase in nocturnal vision after 1 year of adapted retinol supplementation.
Low vitamin A levels occur frequently in clinically stable, eutrophic and retinol supplemented CF adolescents. Since vitamin A deficiency is associated with poor nocturnal vision and since this pattern can be reversed by adapted retinol supplementation, we recommend monitoring plasma vitamin A levels in CF patients and evaluation of dark adaptation in retinol deficient patients.
本研究的目的是记录十名患有囊性纤维化（CF）且营养良好的青少年在每日补充视黄醇情况下的血浆视黄醇状态和夜间视力。对十名临床状况稳定的CF患者（平均年龄：14.3岁；施瓦赫曼评分：80 - 100）测量了血浆视黄醇、α和β胡萝卜素以及视黄醇结合蛋白。用拜恩验光仪进行夜间视力评估。除一名患者外，所有患者的血浆视黄醇（平均0.42±0.16mg/l）、α胡萝卜素和β胡萝卜素水平均低于正常下限。在十名标准眼科检查正常的患者中，有五名患者的暗适应测试结果较差（3名患者）或呈病理性（2名患者）。这两名患者在接受适应性视黄醇补充1年后夜间视力有显著提高。
在临床状况稳定、营养良好且补充视黄醇的CF青少年中，维生素A水平经常较低。由于维生素A缺乏与夜间视力差有关，且这种情况可通过适应性视黄醇补充得到改善，我们建议监测CF患者的血浆维生素A水平，并对维生素A缺乏的患者进行暗适应评估。
