Lewallen S, Taylor T E, Molyneux M E, Semba R D, Wills B A, Courtright P
British Columbia Centre for Epidemiologic and International Ophthalmology, Vancouver, Canada.
Arch Ophthalmol. 1998 Mar;116(3):293-6. doi: 10.1001/archopht.116.3.293.
To investigate the relationship between serum vitamin A levels and conjunctival impression cytology and retinal whitening present in Malawian children with cerebral malaria.
Standard retinal examination and conjunctival impression cytology were performed at hospital admission on 101 consecutively admitted children with cerebral malaria. Blood samples were drawn from 56 children at 24 hours, frozen at -20 degrees C, and transported for assessment of vitamin A levels by high-performance liquid chromatography. Associations among fundus findings and vitamin A measurements were sought.
The whitening of the retina that we have previously described in children with cerebral malaria was found to be associated with a mean+/-SD serum vitamin A level of 0.29+/-0.1 micromol/L, compared with a mean vitamin A level of 0.41+/-0.2 micromol/L in children without retinal whitening. Children with retinal whitening were 2.77 (95% CI, 1.06-7.3) times more likely to have abnormal conjunctival impression cytology results than those without whitening. No child had any clinical or ophthalmologic evidence of chronic vitamin A deficiency.
The retinal whitening described in children with cerebral malaria is associated with low serum vitamin A levels and with abnormal conjunctival impression cytology results and may be due to acute vitamin A deficiency at the tissue level.
探讨马拉维脑型疟患儿血清维生素A水平与结膜印迹细胞学及视网膜白化之间的关系。
对101例连续收治的脑型疟患儿入院时进行标准视网膜检查和结膜印迹细胞学检查。在24小时时从56例患儿采集血样，于-20℃冷冻，并运送至实验室通过高效液相色谱法评估维生素A水平。探寻眼底检查结果与维生素A测量值之间的关联。
我们之前描述的脑型疟患儿视网膜白化现象，被发现与血清维生素A水平平均为0.29±0.1微摩尔/升相关，而无视网膜白化的患儿维生素A平均水平为0.41±0.2微摩尔/升。有视网膜白化的患儿结膜印迹细胞学检查结果异常的可能性是无白化患儿的2.77倍（95%可信区间，1.06 - 7.3）。没有患儿有慢性维生素A缺乏的任何临床或眼科证据。
脑型疟患儿中所描述的视网膜白化与血清维生素A水平低及结膜印迹细胞学检查结果异常相关，可能是由于组织水平的急性维生素A缺乏所致。
