补充维生素A与铁对改善学龄前儿童贫血和免疫功能的影响

Effects of vitamin A and iron supplementation on the improvement of iron status and immunological function in preschool children

目的 为观察学龄前儿童亚临床维生素A(VA)缺乏状态缺铁时 ,机体免疫功能的变化以及VA与铁同时补充对改善儿童铁营养状况和免疫功能的影响。方法 检测北京农村 2 70名 3～ 7岁儿童血清VA含量和血红蛋白 (Hb)、血清铁 (SI)、运铁蛋白饱和度 (TS)及血清铁蛋白 (SF)后 ,将其分为正常、低VA、低铁和低VA低铁 4组 ,每组选 40人 ,检测血清免疫球蛋白IgA、IgG、IgM与白细胞介素 2 (IL 2 )。然后将低VA低铁组儿童随机分为补铁组 (每日口服相当于 30mg元素铁的硫酸亚铁 ,连续 8周 )和补VA +铁组 (口服VA胶丸 12 5 0 0IU/次 ,2次 /周 ,连续 8周 ;口服铁量同补铁组 ,连续 8周 ) ,分别进行干预。干预后重复检测血清VA、血液铁生化指标和以上免疫指标 ,进行两组间比较 ,并与干预前比较。结果 低VA低铁组儿童血清IgM为 (12 6 0± 310 )mg/L显著高于正常组的 (10 70±170 )mg/L。对其实施VA +铁联合干预后 ,血清TS为 (2 6 5± 8 6 ) % ,明显高于补铁前的 (16 2±1 6 ) %和单纯补铁组的 (2 2 3± 3 8) % ;IL 2在VA与铁同时补充后为 (2 78 9± 117 7)ng/L ,显著高于补充前的 (16 1 6± 90 3)ng/L和单纯补铁组的 (189 5± 89 3)ng/L的水平 ;其他铁生化指标和免疫指标无明显变化。结论 对存在亚临床VA缺乏状态的缺?

Objective In order to understand the changes in immunological function in rural preschool children with lower levels of vitamin A and iron, and the effect of vitamin A and iron supplementation on the improvement of iron status and immunological function. Methods Serum vitamin A concentration and hemoglobin (Hb), serum iron (SI), transferrin saturation (TS), serum ferritin (SF) were determined in 270 rural preschool children aged 3 7 years in Beijing, and the subjects were divided into four groups based on their determinations: control, lower serum vitamin A, lower iron, and both lower iron and serum vitamin A Forty subjects were selected from each group, and serum IgA, IgG, IgM and interleukin 2 (IL 2) were determined for them Forty one subjects who had lower iron and lower serum vitamin A (<1 12 μmol/L) were divided into two groups: one of them supplemented with 30 mg iron element (ferrous sulfate 0 15 g) once a day for 8 weeks, and the other group supplemented with iron and 12 500 IU vitamin A twice a week for 8 weeks After supplementation of vitamin A and iron, their serum vitamin A, hematological iron index and serum immunological index were determined again for the two groups. Results Serum IgM were (1 260±310) mg/L in both lower iron and serum vitamin A groups, significantly higher than that in normal group (1 070±170) mg/L ( P <0 05) But there were no significant differences in serum levels of IgG, IgA and IL 2 After supplementation of iron and vitamin A, their serum TS increased to (26 5±8 6)%, significantly higher than that before supplementation and that supplemented with iron only (22 3±3 8)% And, their serum IL 2 were (278 9±117 7) ng/L after supplementation, significantly higher than that before supplementation (161 6±90 3) ng/L and that in those supplemented with iron only (189 5±89 3)ng/L There was no significant difference in other biochemical indices of iron and immunological indices. Conclusions Supplementation with vitamin A and iron was helpful to improve body iron nutritional status and immunological function obviously in preschool children with iron deficiency and sub clinical deficiency of vitamin A