婴儿维生素A营养状况与乙型肝炎疫苗免疫效果关系的研究  

Relationship between the nutritional status of vitamin A and HBV immune effect in infants

作　　者：马爱勤[1] 潘筱 李光彩 季永芳 石庆香 汪之顼 孙忠清 钟春梅 沈遥 

机构地区：[1]上海市第六人民医院奉贤分院上海市奉贤区中心医院营养科,201400

出　　处：《中国综合临床》2012年第9期920-924,共5页Clinical Medicine of China

基　　金：山东省科技发展计划项目（2009GG10002017）

摘　　要：目的探讨婴儿维生素A营养状况及其与乙型肝炎表面抗体水平的关系。方法通过山东省临沂市梅埠镇和蒙阴县人民医院计划免疫接种机构，采集符合纳人条件的198例婴儿静脉血2ml，对婴儿照料者进行24h膳食回顾调查和2Et膳食记录相结合的方法，了解婴儿连续72h进食的食物及数量。采用营养素计算软件，计算每人每日各种营养素的平均摄入量，并计算其占推荐摄入量（RNI）或适宜摄入量（AI）百分比。血清维生素A浓度采用高效液相色谱法测定，血清乙型肝炎病毒表面抗体浓度采用电化学发光免疫分析法（ECLIA）测定。比较亚临床维生素A缺乏组（87例），可疑亚临床维生素A缺乏组（51例）及正常组（60例）抗-HBs浓度对数值的差异及维生素A浓度与抗-HBs浓度对数值的关系。结果当地维生素A摄入量只有19．7％的婴儿达到RNI的80％；维生素A营养不良发生率为67．2％；乙型肝炎抗体平均几何浓度是402．8U／L，阳性率为98．0％，亚临床维生素A缺乏组、可疑亚临床维生素A缺乏组及正常组之间抗-HBs浓度对数值，差异有统计学意义（F=15．88，P〈0．001），血清维生素A浓度与抗-HBs浓度对数值的相关系数为0．441（P=0．01）。结论血清维生素A可能与抗-HBs抗体有效保护水平的维持有一定关系。Objective To explore the relationship between the status of vitamin A and the level of Anti- HBs in infants. Methods One hundred and ninty eight infants met the criteria were recruited into an investigation through local vaccination service. Two milliter venous blood was drawn from each studied child, and the infants＇ feeding information of successive 72 hours was collected through the 24-hour dietary recall method and 2-day diet records method. The nutrients intakes were analyzed with a NCCW software for calculation. The concentration of serum vitamin A and Anti-HBs was analyzed by HPLC and ECLIA, respectively. The logarithm of anti-HBs concentrations was compared among sub-clinical vitamin A deficiency （87 cases ）, suspicious subclinical vitamin A deficient group（51 cases）and normal group （60 eases）and the relationship between the logarithm of anti-HBs concentrations and vitamin A were analyzed. Results There were only 19. 7% of children whose average daily intake of vitamin A reached the 80% of recommended nutrient intakes（RNI）. The incidence rate of vitamin A malnutrition was 67. 2%. The serum Anti-HBs GMC was 402. 8 U/L. The positive rate was 98.0%. There were significant differences on Anfi-HBs lg GMC between Sub-clinical vitamin A deficiency （SVAD） group, suspicious SVAD group and normal group （ F = 15.88, P 〈 0. 001 ）. The correlation coefficient between the level of serum vitamin A and Anti-HBs lg GMC was 0. 441 （ P = 0. 01 ）. Conclusion The results show that the level of serum vitamin A may have influence on the maintenance of an effective anti-HBs level against hepatitis B virus.

关 键 词：婴儿 维生素A 乙型肝炎疫苗 免疫应答 

分 类 号：R186[医药卫生—流行病学]