维生素K选择性应用在预防母乳喂养婴儿维生素K缺乏症的临床研究  

The effect of individualized prophylaxic vitamin K supplement on the preventing of vitamin K deficiency in total breast-fed small infants

作　　者：张佩敏[1] 胡建强[1] 张治萍[1] 唐秀华[1] 钱俏[1] 李卫国[1] 倪健儿[1] 

机构地区：[1]上海市浦东新区人民医院儿科,201200

出　　处：《中国新生儿科杂志》2006年第5期257-260,共4页Chinese Journal of Neonatology

基　　金：上海市浦东新区社发局基金资助项目(PW2001-06)

摘　　要：目的探讨维生素K选择性应用在预防婴儿维生素K缺乏症的临床效果。方法采用胶乳凝集半定量法对90例婴儿脐血血浆异常凝血酶原(PIVKA-Ⅱ)阳性状况进行筛检。实验组(选择性维生素K1干预组)45例纯母乳喂养婴儿根据检测结果,采用不同剂量、不同疗程、不同方式的维生素K予以选择性补充;对照组(常规维生素K1干预组)45例纯母乳喂养婴儿采用一次性肌注维生素K11mg的常规方法补充。至出生后第45、90天时复查血浆PIVKA-Ⅱ浓度,观察结果。结果90例婴儿中有42例脐血PIVKA-Ⅱ呈阳性,阳性率为46·7%。实验组和对照组脐血PIV-KA-Ⅱ阳性者分别为19例、23例,阳性率分别为42·2%、51·1%(χ2=0·71,P>0·05)。干预后实验组和对照组出生45、90d时血浆PIVKA-Ⅱ阳性发生率分别降为0%、33·3%(χ2=18·00,P<0·001)和0%、15·6%(χ2=5·58,P<0·05)。经脐血筛查后选择性补充维生素K1的干预方法,明显优于常规一次性肌注维生素K1的干预方法。结论维生素K选择性应用对母乳喂养婴儿维生素K缺乏症的预防效果满意。Objective To recommend an appropriate Vitamin K supplement method to total breast-fed small infants. Methods Ninety newborn infants were involved and followed up to 3 months old. Their umbilical cord blood and blood at 45 and 90 days of life was collected to detect serum protein induced by Vitamin K absence or antagonists-Ⅱ（PIVKA-Ⅱ ） to screen their Vitamin K condition by using latex agglutination test. They were total breast fed until 3 months old. Forty-five infants （control group） received Vitamin K1 lmg intra-muscular injection immediately after birth for one time, and the others （study group） received Vitamin K1 according to their PIVKA-Ⅱ levels following the Vitamin K supplement suggestion in China. Results PIVKA-Ⅱ positive rate was 46.7% in 90 newborns, and it was 42. 2% in control group and 51.1% in study group respectively, X^2=0. 71, P 〉 0.05. After Vitamin K supplement, PIVKA-Ⅱ positive rate at control and study group dropped to 33.3% and 0% at 45 days of life, x^2 = 18.00,P 〈0. 001 ; and to 16. 5% and 0% at 90 days of life, X^2 =5.58 ,P 〈0.05. Conclusions More than 40% newborn infants present sub-clinical Vitamin K deficiency during their fetal life. Individualized Vitamin K supplement can provide better prevention effect.

关 键 词：婴儿 维生素K缺乏 母乳喂养 血浆异常凝血酶原 

分 类 号：R723[医药卫生—儿科]