婴儿维生素K缺乏及其干预的研究  

Vitamin K deficiency and intervention among infants

作　　者：林良明[1] 刘玉琳[1] 鲁杰[1] 张新利[1] 赵小元[1] 崔秀生[2] 何守森 周风荣 谢鹏[4] 梁友玲[5] 林超琼[5] 黎洁芳 朱岩[7] 宋华[8] 高清欣 冯红旗 易惠生 郑洁[10] 

机构地区：[1]首都儿科研究所流行病研究室,北京100020 [2]首都医科大学 [3]山东省妇幼保健所 [4]湖南省妇幼保健院 [5]广西壮族自治区妇幼保健院 [6]韶关市妇幼保健院 [7]甘肃省妇幼保健院 [8]江门市妇幼保健院 [9]河南省妇幼保健院 [10]湖北省妇幼保健院

出　　处：《中华儿科杂志》2002年第12期728-732,共5页Chinese Journal of Pediatrics

摘　　要：目的　了解中国婴儿VKD情况 ,评价婴儿及乳母口服维生素K干预效果。方法　采集7省活产婴儿脐血 5 47份 ,用ELISA法测定PIVKA Ⅱ浓度。对 7省活产婴儿 1975 1人整群随机抽样分为婴儿干预组 (VitK12mg 10次 ,口服 )和对照组 (不使用VitK1) ,哺乳母亲 2 13 68人 ,整群随机抽样为母亲干预组 (VitK110mg 10次 ,口服 )和对照组 (不使用VitK1)。所有观察对象检测婴儿至满 6个月。观察期间干预组及对照组的全部出血病例 ,VKDB ,及其死亡和残疾病例全部以专门表格登记。结果　 ( 1)城市足月婴儿脐带血proteininducedbyVitaminKabsence (PIVKA Ⅱ )阳性率 3 2 8% ( 85 /2 5 9) ,农村 65 8% ( 96/146) ,城乡足月婴儿脐带血PIVKA Ⅱ阳性率差异有显著意义 ( χ2 =41 0 ,P <0 0 0 1)。( 2 )婴儿VitK1干预组 10 418例 ,4例发生出血 ,其中 2例为VitaminKdeficiencybleeding (VKDB) ,无死亡 ,无残疾 ,无 1例晚发性VKDB病例。对照组 93 3 3人 ,5 2例发生出血 ,其中 3 0例VKDB( 2 1例晚发性VKDB) ,15例死亡 ,3例残疾 ,其中 9例死亡 ,3例残疾由于VKD。 ( 3 )乳母VitK1干预组 10 5 18例 ,8例发生出血 ,2例死亡 ,无残疾及晚发性VKD病例 ,2例死亡者排除VKD。对照组 10 85 0例 ,5 0例婴儿发生出血 ,其中VKDB(晚发性 9例 )。Objective To detemine the status of vitamin K deficiency (VKD) among infants in China and evaluate the effect of intervention with oral vitamin K 1 (VitK 1) for infants and lactating mothers. Methods In 7 provinces, 547 samples of cord blood from live births were collected to measure plasma protein induced by Vitamin K Absence (PIVKA-Ⅱ) concentrations with ELISA method. In the rural areas of those 7 provinces, 19 751 infants were selected with cluster-random-sampling and then were divided into intervention group (VitK 1 2 mg×10 orally) and control group (no administration of VitK 1), 21 368 lactating mothers were selected with cluster-random-sampling and then divided into intervention group (VitK 1 10 mg×10 orally) and control group (no administration of VitK 1). All bleeding cases, Vitamin K deficiency bleeding (VKDB), deaths and deformities in the intervention groups and the control groups were recorded with a special table. All subjects were monitored for their first 6 month after birth. Results (1) PIVKA-Ⅱpositive rate of cord blood among full-term infants was 32.8% (85/259) in the urban and 65.8% (96/146) in the rural areas. The difference in positive rates between the urban and the rural areas was significant (χ 2=41.0, P<0.001). (2) In infant intervention group, 4 of 10 418 infants suffered from bleeding, 2 cases had VKDB. No death, no deformity and no late Vitamin K deficiency bleeding (LVKDB) were found. In control group (9 333 infants) 52 cases suffered from bleeding and 30 cases had VKDB (21 LVKDB). Fifteen deaths and 3 deformities were found, among them 9 deaths and 3 deformities were due to VKD. (3) In mother intervention group (10 518 mothers), 8 infants suffered from bleeding and 2 deaths were recorded. No deformity, nor LVKDB were found. But the 2 deaths were not caused by VKD, In control group (10 850 mothers) 50 infants suffered from bleeding, 22 had VKDB (9LVKDB). Among 14 deaths and 5 deformities, 4 deaths and 3 deformities were due to VKD. (4) PIVKA-Ⅱ and VitK 1 concentr

关 键 词：婴儿 维生素K缺乏 干预性研究 血清 流行病学 

分 类 号：R723[医药卫生—儿科]