Pneumonia is a common infectious disease in pediatric clinical practice and an important public health problem worldwide. According to the World Health Organization (WHO), pneumonia is the leading cause of death among children under five years of age.
The incidence of pneumonia has obvious seasonality, and the incidence rate in winter and spring is high. Infants under 1 year old are high-risk groups, and they are also the key population for prevention and control of pneumonia. At present, the clinical path of pediatric pneumonia is relatively clear, and the principle of treatment is to improve lung ventilation function, effectively control inflammation, and avoid complications.
Meta-analysis showed that the combination of vitamin A in treatment can improve the total clinical effective rate (P<0.0001), shorten the duration of fever (P=0.02), cough duration (P=0.0007), and the lungs rale disappeared Time (P < 0.0001), signs and chest radiotelepage time (P = 0.002), hospital stay (P < 0.00001), and did not increase the incidence of adverse reactions (P > 0.05).
In addition, the meta-analysis showed that vitamin A supplementation reduced the number of respiratory infections and pneumonia in infants at 6 months.
Vitamin A, also known as retinol, has many physiological functions such as promoting visual function, immune function, growth and hematopoiesis, and is essential for the growth and development of children. Global epidemiological data show that the incidence of vitamin A deficiency in children in developing countries is still high, especially sub-clinical vitamin A deficiency is still a public health problem affecting children.
■ Recent studies have found that vitamin A deficiency is significantly associated with the development of pneumonia. Vitamin A deficiency can aggravate pneumonia, which in turn leads to an increase in vitamin A deficiency.
A retrospective analysis of children with acute pneumonia showed that plasma vitamin A levels were significantly lower in children with pneumonia than in healthy children, and children with vitamin A deficiency were more likely to be associated with bacterial infections. The study found that the vitamin A level in children with severe pneumonia was significantly lower than that in the mild pneumonia group, and the detection rate of vitamin A deficiency was higher, indicating that the level of vitamin A in children with pneumonia has a certain correlation with the severity of pneumonia. Vitamin A level The lower the risk of severe pneumonia, the higher the risk. Studies have shown that the level of vitamin A in children with pneumonia is closely related to the condition, body temperature and course of disease. That is, the more severe the condition of the child with pneumonia, the longer the course of the disease, the higher the subclinical vitamin A deficiency rate, including pneumonia with fever, diarrhea and fever. Children, the higher the subclinical vitamin A deficiency rate.
■ Further analysis of the association between vitamin A deficiency and pneumonia may be related to the following:
(1) Vitamin A deficiency can cause squamousization of respiratory mucosal epithelial cells, causing epithelial cells to keratinize and shed, and at the same time reduce IgA secretion, thereby reducing the body’s defense ability and resistance to viruses and bacterial microorganisms, eventually leading to pneumonia;
(2) Pneumonia will further damage the airway epithelial cells, and repairing these injuries will consume a lot of vitamin A, further aggravating vitamin A deficiency;
(3) pneumonia can lead to decreased digestion and absorption of the gastrointestinal tract, reducing the body’s intake of vitamin A in food, further aggravating vitamin A deficiency;
(4) pneumonia can lead to a decrease in the synthesis of retinol-binding protein, a decrease in the ability of the liver to transport vitamin A, and a decrease in plasma vitamin A content;
(5) The excretion of vitamin A in the urine of patients with pneumonia increases, resulting in increased loss of vitamin A. The study showed that patients with pneumonia lost an average of 0.88 μmol / d of retinol, while the normal population was only 0. 18 μmol / d.
In summary, vitamin A deficiency increases the risk of respiratory infections and digestive tract infections in children, and daily supplementation of physiological requirements of vitamin A (1500 to 2000 units) can effectively prevent the incidence of infectious diseases in children. For children who already have infectious diseases, supplementation with vitamin A on the basis of conventional treatment can shorten the course of the disease, improve symptoms, and prevent recurrence.
Therefore, infants and preschool children should pay attention to the nutritional level of vitamin A, promote daily small-dose preventive supplements, prevent the occurrence of infectious diseases, and provide protection for children’s healthy growth!