Black R E
Department of International Health, School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Clin Nutr. 1998 Aug;68(2 Suppl):476S-479S. doi: 10.1093/ajcn/68.2.476S.
In children in developing countries, zinc deficiency may be common and associated with immune impairment and increased risk of serious infectious diseases such as diarrhea, pneumonia, and malaria. Studies have evaluated the therapeutic effects of zinc supplementation during acute or persistent diarrhea. In studies of acute diarrhea, the illness duration has been found to be 9-23% shorter in zinc-supplemented than in control children. Diarrhea was also less severe in zinc-supplemented children. In studies of persistent diarrhea, the effect sizes were similar but were often not statistically significant, perhaps because of the small number of children participating in these studies. Trials that provided continuous daily zinc supplementation for 5-15 mo evaluated effects on the incidence of diarrhea and in some studies acute lower respiratory infections and malaria. The reduction in the incidence of diarrhea in the zinc-supplemented group in these studies ranged from 8% to 45%. A study that gave 2 wk of zinc supplementation found preventive effects against diarrhea for the 3 mo of surveillance. More limited data also suggest that the incidence of acute lower respiratory infection and clinical attacks of malaria may also be reduced by zinc supplementation. If these results are confirmed by meta-analysis of the existing trials and additional research, improvement of zinc nutriture should become a priority intervention to reduce the high burden of serious infectious disease in children in developing countries.
在发展中国家的儿童中，锌缺乏可能很常见，并与免疫功能受损以及患腹泻、肺炎和疟疾等严重传染病的风险增加有关。已有研究评估了在急性或持续性腹泻期间补充锌的治疗效果。在急性腹泻的研究中，发现补充锌的儿童的病程比对照组儿童短9%至23%。补充锌的儿童腹泻也不那么严重。在持续性腹泻的研究中，效应大小相似，但往往没有统计学意义，这可能是因为参与这些研究的儿童数量较少。持续每日补充锌5至15个月的试验评估了对腹泻发病率的影响，在一些研究中还评估了对急性下呼吸道感染和疟疾的影响。在这些研究中，补充锌组腹泻发病率的降低幅度为8%至45%。一项给予2周锌补充剂的研究发现，在3个月的监测期内对腹泻有预防作用。更有限的数据还表明，补充锌也可能降低急性下呼吸道感染和疟疾临床发作的发病率。如果现有试验的荟萃分析和更多研究证实了这些结果，改善锌营养状况应成为减轻发展中国家儿童严重传染病高负担的优先干预措施。
