我国7省市新生儿维生素K缺乏诱导蛋白流行病学调查

An Epidemiological Survey on Protein Induced by Vitamin K Absence or Antagonist in Newborns from 7 Provinces in China.

【目的】 阐明我国 7省市新生儿维生素K缺乏诱导蛋白水平以及维生素K缺乏流行病学状况。 【方法】 采用ELISA法对我国 7省市 40 5例健康足月婴儿和 14 2例早产婴儿脐血PIVKA Ⅱ进行测定。 【结果】 ①40 5例足月婴儿脐血PIVKA Ⅱ阳性率为 44.7%( 181/4 0 5 ) ,其中男婴为 43.5 %( 93/2 14 ) ,女婴为 46 .1%( 88/191)。 14 2例早产婴儿脐血PIVKA Ⅱ为 43.0 %( 6 1/14 2 ) ,其中男婴为 45 .3%( 34/75 ) ,女婴为 40 .3%( 2 7/4 0 ) ,二者性别无统计学意义。②城市和农村出生足月婴儿和早产婴儿脐血PIVKA Ⅱ阳性人群 2～ 9ng/ml范围最多 ,亦占 44.2 %,但在 >2 0 0ng/ml极重度阳性亦占 10 .3%。③PIVKA Ⅱ阳性率随月龄增加而降低 ,但 2月龄时其阳性率仍为 14 .3%。④城市新生儿PIVKA Ⅱ阳性率随出生体重增加和孕周增加而呈现下降趋势。 【结论】 我国新生儿和婴儿存在较严重维生素K缺乏亚临床现象 ,应大规模实施维生素K预防干预的措施。

To investigae plasma level of protein induced by vitamin K absence or antagonist(PIVKA-Ⅱ) and the status of vitamin K deficiency in newborns from 7 provinces in China. PIVKA-Ⅱ value of 405 health full-term newborns and 142 prematures was measured by enzyme-linked immunosorbent assay(ELISA). The proportion of PIVKA-Ⅱ positive was 44.7%(boy 43.4%,girl 46.1%) in full-term newborns,42.9%(boy 45.3%,girl 40.3%) in prematures,respectively.There was no significant differences between sex groups.The positive degree of PIVKA-Ⅱ 44.2% was in 2～9ng/ml and 10.3% was in>200ng/ml range in newborns and prematures of cities and urban from 7 provinces in China.The incidence of PIVKA-Ⅱ positive newborns decreased with birth age increment,the positive PIVKA-Ⅱ of 14.3% still was in 2 month old baby.The difference among groups were very significant(χ 2=22.6,P<0.01).The positive rate of PIVKA-Ⅱ decreased with increment of birth weight in newborns and in gestational age in cities. [Conclusions] The results indicated that the sub-clinical status of vitamin K deficiency was relatively high in full-term newborns and prematures from 7 provinces in china,to which enogh attention should be paid.The vitamin K prophylaxis should be propagated in newborns.