中国作者重要发表 - 维生素A用于7岁以下儿童下呼吸道感染的预防



维生素A用于7岁以下儿童下呼吸道感染的预防





Vitamin A for preventing acute lower respiratory tract infections in children up to seven years of age





Chen H., Zhuo Q., Yuan W., Wang J., Wu T. 2009/5/29 18:39:20

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Cochrane Database of Systematic Reviews, 2008, Volume 0, Issue 1




Background: Vitamin A supplements are effective for preventing diarrhoea. There are theoretical reasons it might also be effective for acute lower respiratory tract infections (LRTIs), also very common in children, especially in low income countries. Objectives: To assess the effectiveness and safety of vitamin A for preventing acute LRTIs in children up to seven years of age. Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 2); MEDLINE (1966 to July 2007); EMBASE (1974 to July 2007); and the Chinese Biomedicine Database (CBM) (1976 to July 2007). Selection criteria: Randomised controlled trials (RCTs) that assessed the effectiveness of vitamin A in the prevention of acute LRTI in children up to seven years of age. Data collection and analysis: The review authors independently extracted data and assessed trial quality. Study authors were contacted for additional information. Main results: Most studies found no significant effect of vitamin A on the incidence of acute LRTI, or prevalence of symptoms of acute LRTI. Vitamin A caused an increased incidence of acute LRTI in one study; an increase in cough and fever; and increased symptoms of cough and rapid breathing in two others. Three reported no differences and no protective effect of vitamin A. Two studies reported that vitamin A significantly reduced the incidence of acute LRTI with children with poor nutritional status or weight, but increased it in normal children. Authors' conclusions: This unexpected result is outside our current understanding of the use of vitamin A for preventing acute LRTIs. Accordingly, vitamin A should not be given to all children to prevent acute LRTIs. There is evidence for vitamin A supplements to prevent acute LRTIs in children with low serum retinol or those with a poor nutritional status. Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.



Correspondence Address: Wu, T.; Chinese Cochrane Centre, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu Sichuan 610041, China; email: txwutx@hotmail.com



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高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
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心力衰竭	心律失常

病例分析

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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