目的 分析维生素A缺乏(VA)与新生儿感染性肺炎发病的关系,为临床诊治提供参考依据。方法 选取2018年1-6月门诊患儿206例,检测其血清VA水平,比较不同VA水平患儿的感染性肺炎发病率,按照是否罹患感染性肺炎以及肺炎的严重程度不同,比较分组间VA水平的差异;对于肺炎患儿随机分为实验组及对照组,对照组采用常规治疗,实验组在常规治疗基础上给予口服VA 1 500 U/d,对临床治疗效果进行比较。结果 1)206例新生儿中,116例存在VA缺乏,51例存在边缘型VA缺乏,39例正常水平。VA水平越低,感染性肺炎发病率越高,差异有统计学意义(χ²=10.02,P=0.007)。2)肺炎组患儿VA水平[(0.182±0.079) mg/L]显著低于非肺炎组[(0.236±0.098) mg/L],差异有统计学意义(t=4.570,P<0.001)。重度肺炎患儿血清VA[(0.125±0.041)mg/L]显著低于轻度肺炎患儿VA水平[(0.212±0.078)mg/L],差异有统计学意义(t=4.62,P<0.001)。3)VA辅助治疗后实验组患儿气促、咳嗽、呛奶、肺部啰音等临床症状持续时间显著低于对照组,差异有统计学意义(P<0.05)。结论 新生儿血清VA水平与新生儿感染性肺炎发病存在紧密联系,低剂量维生素A佐治新生儿感染性肺炎疗效显著,可明显缩短临床症状持续时间。

Objective To analyze the relationship between vitamin A (VA) deficiency and neonatal infectious pneumonia. Methods A total of 206 outpatient term infants were enrolled in this study from January to June 2018,and the VA level of infants were tested.The prevalence rates of infectious pneumonia in neonates with different VA levels were compared.And VA levels were compared between groups according to whether they had infectious pneumonia and the severity of pneumonia.Newborns with pneumonia were randomly divided into the experimental group and the control group.The control group received conventional treatment,while the experimental group was given oral vitamin A 1 500 U/d additionally.The clinical efficacy was compared between the two groups. Results 1) Among the 206 newborns,116 were with vitamin A deficiency,51 were with marginal vitamin A deficiency,and 39 were in normal levels.Infants with lower the VA level had significantly higher prevalence of infectious pneumonia (χ²=10.02,P=0.007).2) The VA level in pneumonia group [(0.182±0.079) mg/L](t=4.570,P<0.001) was significantly lower than that in the non-pneumonia group[(0.236±0.098) mg/L](t=4.570,P<0.001)].And serum vitamin A [(0.125±0.041) mg/L] was significantly lower in newborns with severe pneumonia than that in newborn with mild pneumonia[(0.212±0.078) mg/L] (t=4.62,P＜0.001).3) After the adjuvant treatment,the durations of clinical symptoms such as shortness of breath,cough,milk choking and lung rales were significantly lessen than those of the control group (P＜0.05). Conclusions The neonatal serum VA level is closely related to the incidence of pneumonia. And small dose of vitamin A is effective in the treatment of neonatal infectious pneumonia has distinct curative effect, can shorten the duration of clinical symptoms significanfly.