婴幼儿补充维生素A改善乙肝疫苗再免疫效果的研究及部分城市婴幼儿喂养状况的调查

发布时间：2018-04-27 16:15

本文选题：婴幼儿 + 维生素A　；参考：《青岛大学》2010年硕士论文

【摘要】： 目的观察补充维生素A(VA)对婴幼儿乙肝疫苗再免疫效果的影响。方法2008年10月-2009年3月间,在山东临沂农村地区某乡,招募该乡所有按国家计划免疫常规全程接种过乙肝疫苗且父母无乙肝病史的7-36月龄婴幼儿,检测其血清抗乙型肝炎病毒表面抗原抗体(抗-HBs)浓度,对其中100名血清抗-HBs水平较低的婴幼儿,随机分组,进行随机、双盲、安慰剂对照的VA干预试验。VA补充期3个月,采用市售鱼肝油作为VA补充剂,每15d补充一次,每次2.5万IU,共补充6次；对照组给予等体积玉米油。在干预试验开始后的第30d和第60d,给婴幼儿进行乙肝疫苗再免疫接种,第90天采集婴幼儿血清样本。用高效液相色谱法(HPLC)测定干预试验前后婴幼儿血清VA浓度。用电化学发光免疫分析法(ECLIA)测定血清抗-HBs水平。结果完成全程干预试验的婴幼儿共74名,试验组和对照组各37名,其中失访16例(试验组9例,对照组7例),剔除自行额外服用含VA营养补充剂者7例(试验组2例,对照组5例),采血失败3例(试验组2例,对照组1例)。两组儿童干预前血清VA水平和抗-HBs水平无差异(均为P0.05)。干预后,VA补充组儿童的血清VA浓度、血清抗-HBs水平皆高于对照组(404.1±123.1μg/L vs240.8±92.8μg/L和2737.2±2492.6 mIU/mL vs 1199.7±2141.6 mIU/mL,均为P0.05)。VA补充组乙肝疫苗弱、无应答率(0)低于对照组(4%)。结论补充VA可显著提高婴幼儿乙肝疫苗再免疫后血清抗-HBs水平,显示VA营养状况是确保乙肝疫苗效果的重要因素。目的了解中国部分大城市婴幼儿的喂养现状,为开展改善婴幼儿喂养状况的营养宣教提供依据。方法在北京、天津及青岛三市的各两所大型三甲医院的预防保健门诊,对前来进行预防接种的1773例5-14月龄婴幼儿的家长进行了喂养状况的问卷调查,同时测量婴幼儿生长发育指标。结果调查的婴幼儿群体性别分布均衡,平均年龄为9.1±2.3月龄,青岛婴幼儿月龄稍高,婴幼儿生长发育适宜者1246例(70.3%,其中北京431例,天津385例,青岛430例)。三城市婴幼儿出生后吃的第一口食物按所占比例的多少,依次为婴儿配方奶、白水、母乳、糖水、牛奶,北京依次为母乳、婴儿配方奶等；天津依次为白水、糖水等；青岛依次为婴幼儿配方奶、母乳等。三城市婴幼儿基本纯母乳喂养时间平均持续2.8个月,青岛平均持续2.5个月,北京平均持续3.3个月,天津平均持续3.8个月；三城市婴幼儿母乳喂养持续时间平均为7.1个月,青岛为7.3个月,北京6.4个月,天津7.6个月；。三城市婴幼儿6个月母乳喂养率为89.6%(1588人,其中北京574人,天津461人,青岛553人),6个月基本纯母乳喂养率为33.6%(597例,其中北京115例,天津253例,青岛553例)。辅食添加的第一种食物按其所占比例的多少,依次为蛋黄、米粉、果(菜)汁、自制其他食物。婴幼儿服用的营养素补充剂换按其所占比例的多少,依次为维生素AD、钙、益生菌、DHA、锌、铁、牛初乳、蛋白粉、其他,北京依次为钙、维生素AD、益生菌、锌等,天津依次为维生素AD、钙、益生菌、铁等,青岛依次为维生素AD、钙、DHA、锌等。结论三城市部分婴幼儿中仍存在着喂养不合理的问题,需要给予相应的营养宣传和教育。
[Abstract]:Objective To observe the effect of vitamin A (VA) on the effect of re immunization of hepatitis B vaccine in infants. Methods in a rural area of Linyi, Shandong, in October 2008, in a rural area of Linyi, Shandong, all the children of the country were recruited to be vaccinated with hepatitis B vaccine and the parents had no history of hepatitis B in the whole course of the national planned immunization. Virus surface antigen antibody (anti -HBs) concentration, randomly divided 100 infants with low serum anti -HBs level, randomized, double blind, placebo controlled VA intervention test for 3 months, using commercial cod liver oil as a VA supplement, supplemented once per 15d, 25 thousand IU each time, supplemented 6 times; and the control group was given equal volume of corn. Oil. After the intervention test started 30d and 60d, the infants were vaccinated for hepatitis B vaccine, and the serum samples were collected for ninetieth days. The serum VA concentration was measured by high performance liquid chromatography (HPLC) before and after the intervention test. The serum anti -HBs level was measured by electrochemiluminescence immunoassay (ECLIA). The whole course intervention was completed. There were 74 infants in the test, 37 in the experimental group and the control group, of which 16 cases were lost (9 cases in the test group and 7 cases in the control group), and 7 cases (2 cases in the experimental group and 5 cases in the control group) were removed, 3 (2 cases in the experimental group and 1 in the control group), and there was no difference between the serum level and the anti -HBs level of the serum and the anti -HBs level before the intervention of the children in the two group (all P 0.05). After the intervention, the serum VA concentration in the VA supplementation group and the serum anti -HBs level were higher than those in the control group (404.1 + 123.1 mu g/L vs240.8 + g/L and 2737.2 + 2492.6 mIU/mL vs 1199.7 + 2141.6 mIU/mL, all P0.05).VA supplementation group, and the non response rate (0) was lower than that of the control group (4%). Conclusion supplementary VA could significantly improve the hepatitis B epidemic in infants and young children. The level of serum anti -HBs after revaccination showed that VA nutritional status is an important factor to ensure the efficacy of hepatitis B vaccine.
Objective to understand the feeding status of infants and infants in some large cities in China, and to provide the basis for nutrition education to improve the feeding status of infants. Methods the feeding status of 1773 cases of 5-14 month old infants and young children who were vaccinated in two large three A hospitals in three cities of Beijing, Tianjin and Qingdao were given. The gender distribution of infants and young children was balanced, the average age was 9.1 + 2.3 months old, the age of infants in Qingdao was slightly higher, and 1246 cases were suitable for infant growth and development (70.3% in Beijing, 431 in Beijing, 385 in Tianjin, 430 in Qingdao). The first food for infants and young children after birth. According to the proportion of the proportion of the infant formula milk, white water, breast milk, sugar water, milk, Beijing in turn is breast milk, infant formula milk and so on; Tianjin in turn is white water, sugar water and so on; Qingdao in turn is infant formula milk, breast milk and so on. The average time of basic breastfeeding in three cities and young children lasted for 2.8 months, and the average of Qingdao lasted 2.5 months. Beijing lasted 3.3 months on average, and Tianjin lasted for 3.8 months on average; the duration of breast feeding in three cities for infants was 7.1 months, Qingdao was 7.3 months, Beijing was 6.4 months, and Tianjin was 7.6 months. The breastfeeding rate of three cities for 6 months was 89.6% (1588, Beijing 574, Tianjin 461, Qingdao 553). The feeding rate was 33.6% (597 cases, of which 115 cases in Beijing, 253 in Tianjin, 553 in Qingdao). The first food added by the supplementary food was the egg yolk, rice flour, fruit (vegetable) juice and other food in turn. The nutrient supplements taken by infants and young children changed according to the proportion of vitamin AD, calcium, probiotics, DHA, zinc and iron, in turn. Bovine colostrum, protein powder, and other, Beijing in turn is calcium, vitamin AD, probiotics, zinc and so on. Tianjin in turn is vitamin AD, calcium, probiotics, iron and so on. Qingdao in turn is vitamin AD, calcium, DHA, zinc and so on. Conclusion in the three cities and children, there are still problems of feeding irrationality, and the corresponding nutrition publicity and education should be given.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R186

【参考文献】