DINH DUONG
VAI TRO CUA VITAMIN A VOI Sl/PHAT TRIEN CUA TRE
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Hoang Kim Thanh*
Vitamin A cd nhieu chue ndng quan trgng ddi vdi ca thi nhung vdi ngudi ldn tinh trgng thieu vitamin A gdy dnh hudng nghiim trgng tdi sire khde it xdy ra do vitamin A duac du trir tdt a gan vd cd thi dugc huy dgng sir dung trong mdt thdi gian ddi. Do vdy, thudng chi gap thiiu vitamin A a tre em. Vitamin A cd vai trd quan trgng ddi vdi qud trinh phdt triin ciia tre. Thieu vitamin A ldm gidm tdng trudng, tdng nguy ca mdc cdc binh nhiim khudn vd tdng nguy co tu vong a tre. Thieu vitamin A ddn din binh khd mdt cd thi di lgi hdu qud mu Ida vinh viin. Ngirdi me nudi con bu, nhdt la trong 6 thdng ddu bi thiiu vitamin A ddn tdi siia me cung cdp khdng dii vitamin A cho tre, dnh hudng khdng tdt tdi qud trinh ldn cua be.
VAI TRO CUA VITAMIN A TRONG CO THE Vitamin A cb rat nhieu chirc phan trong ea the, trube het la eb vai trb quan trgng dbi vbi qua trinh tang truang. Tre em can vitamin A de phat trien binh thubng.
Vitamin A tham gia trong eau tnic cua cac te bao thi giac (te bao hinh nbn cb vai trb vbi qua trinh nhin khi anh sang tb va te bao hinh que cb vai tro vbi qua trinh nhin khi anh sang yeu). Do vay vitamin A rat can thiet dbi vbi sy nhin thay eua mat. Bieu hien sbm cua thieu vitamin A la kha nang nhin thay liie anh sang yeu giam, nhan dan ta ggi la benh "quang ga".
Vitamin A can thiet eho sy bao ve toan ven cua bieu mb giac mac mat va eae tb ehiic bieu mb dubi da, khi quan, tuyen nubc bgt, niem mac dubng hb hap, tieu hba, tiet nieu... Khi thieu vita- min A san xuat eae niem dieh giam da bi khb va eb hien tugng simg hba, he thbng niem mac bieu mb bj tbn thuang va giam siie de khang dbi vbi sy xam nhap cua vi khuan.
Vitamin A tham gia vao qua trinh dap ung mien dieh, giiip ea the tang eubng sire de khang de
chbng lai sy xam nhap cua vi khuan, virus va eae yeu tb bat lgi.
NGUYEN NHAN BI THiEU VITAMIN A - Do khau phan an bi thieu hyt vitamin A: mgt che do an ngheo nan vbi nhieu chat bgt, it thiic an dbng vat (nhiing thiic an cb ham lugng vitamin A cao) nhu: thit, ca, tning, tbm..., thieu dau ma lam giam hap thu vitamin A (vitamin A hba tan trong dau, mo). Sy thieu hut nay thuang xay ra trong giai dgan tre an bb sung. Siia me la ngubn vitamin A quan trgng cua tre nhb. Tre khbng duge bii me eb nguy ea cao bi thieu vitamin A.
- Tinh trang nhiem khuan, nhiem virut dae biet la khi tre len sbi, viem dubng hb hap, tieu chay la nguyen nhan quan trgng dan tbi tinh trang thieu vi- tamin A. Tre bi nhiem giun, nhat la giun dua eiing la nguyen nhan dan den thieu vitamin A.
- Tre bj suy dinh duong nang thubng kem theo thieu vitamin A. Ngoai ra thilu cac vi ehit khac nhu kem ciing anh hubng tbi chuyen hba vitamin A trong ca the.
*Viin Dinh dudng Qudc gia
S6 48 (Thang 01/2010) Y H O C L A M S A N G j 63
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DINH D U Q N GCAC BIEU HIEN KHI TRE BI THiEU VITA- MIN A
Thieu vitamin A nhe lam giam phat trien ca the, tang nguy ca mac benh nhiem khuan, dae biet la nhiem khuan dubng tieu hba (tieu ehay) va nhiem khuan dubng ho hap (viem dubng ho hap). Thieu vitamin A nang ngoai viec lam giam sire de khang ciia CO the, tre kem phat trien ebn gay nen cae tbn thuang b mat. Cac tbn thuong do neu khbng dugc phat hien sbm va dieu tri kip thai eb the dan den mil 16a vTnh vien. Trieu chimg lam sang ciia thieu vitamin A tien trien nhu sau (theo su phan loai ciia Tb chiic Y te The gibi).
1. Bieu hien sbm nhat la quang ga (ky hieu la XN): quang ga la hien tugng giam thj lye trong dieu kien thieu anh sang. Khi chieu chap choang tbi (lue ga len ehubng), tre mac benh thubng trb nen nhut nhat, chi ngoi yen tai chb, khbng dam di lai hoac chay theo ban diia nghich. Nhiing dira tre Ibn hon khi bi benh thubng di lai khb khan vao bubi tbi, hay vap nga, hay va vap vao nhiing do vat de trong nha nhu nbi nieu, ban ghe; di lai trong nha phai lan tubng do nhin khbng ro. Nhiing tre be hon chua biet di thi khong biet tim nhat nhat do chai vao bubi toi, khong biet tim va cam dung thirc an khi me dua cho ma phai qub quang, tbi den tre cb the theo ngubi khac tubng nham la me. Neu tre dugc phat hien sbm thieu vitamin A a giai dgan quang ga va dugc dieu tri ngay bang vitamin A lieu cao thi benh se khbi nhanh chbng sau 2-3 ngay.
2. Vet Bitot: (ky hieu la XIB): la nhung vet trang, bbng tren mang tiep hgp, thuang cb hinh tam giac, nhu dam bgt xa phbng nho, hay gap a ket mac chb sat ria giac mac, cb the cb b 1 mat hoac ca 02 mat.
Vet Bitot chinh la nhung dam te bao bieu mb ket mac bj khb, day len, simg hba va bong vay. Vet Bitot la trieu chimg dae hieu cua ton thuong ket mac do thieu vitaminA.
3. Kho giac mac: (ky hieu la X2): giac mac trb nen mat do bbng, sang, mb due nhu lan suong phii, cb the san sui, giam cam giac cua giac mac. Kho giac mac hay xay ra b nira dubi giac mac va thuang cb kem theo ca khb ket mac hoac cb vet Bitot. Bieu hien quan trgng nhat la tre sg anh sang hay cup mat nhin xubng, ra sang thuang nham mat. Neu dugc phat hien va dieu tri kip thbi b giai dgan nay cb the phue hbi hoan toan ma khbng de lai di ehiing. Neu khbng dugc dieii tri kip thai eb the dan tbi loet giac mac gay bien chimg nang ne.
4. Loet nhuyen giac mac: (ky hieu la X3A va X3B): loet giac mac la sy mat tb chire mbt phan hay tat ca cae Ibp eua giac mac. Khi khb loet giac mac chua sau, chua bi bbi nhiem nang can phai dieu tri tich cue va kip thbi thi vet Ibet lien nhanh, seo de lai nhb va mbng, thj lye se giam it. Trubng hgp loet sau va rbng, giac mac se bi thung gay phoi mbng mat, teo nhan eau va mil loa vTnh vien.
5. Seo giac mac do khb mat (ky hieu la XS): la di ehung sau khi bi loet giac mac, tiiy theo vi tri va miie do seo (seo Ibi, seo diim) se anh hubng gay giam thi lye hoac gay mil loa khbng hbi phye.
6. Tbn thuong day mat do khb mat (ky hieu la XF): la tbn thuang eua vong mac do thieu vita- min A, bieu hien tinh trang thieu vitamin A man tinh. Tbn thuong thubng gap b tre tubi di hgc co the kem theo quang ga. Soi day mat thay hinh anh vong mac xuat hien cac eham nhb mau trang hoac vang rai rac, dgc theo eae maeh mau vong mac.
Dieu tri bang vitamin A se hbi phue nhanh.
CAC BIEN PHAP PHONG CHONG THIEU VITAMIN A
1. Cai thien de nang cao chat luong bfla an: ehe do an hang ngay can cung cap dii vitamin A va ear- oten. Thyc hien nubi con bang siia me vi siia me la ngubn cung cap vitamin A tbt nhat dbi vbi tre nhb.
64 I Y H O C L A M S A N G 36 48 (Thang oi/2010)
DINH D U O N G
4-
Che do an cua tre cin dugc uu tien thiie an dgng vat la loai thiic an giau vitamin A (trong 100 gam thit ga cb 120 meg vitamin A; trong 100 gam Ign cb 6000 meg vitamiA; trong 100 gam ea tre eb 93 meg vitaminA; trong 100 gam long do tning ga eb 960 meg vitaminA.... Bua an eua tre can eb du dau hoac mb de giup hap thu tbt vitaminA. Mbt sb rau, qua eb mau vang, db, da cam ehiia ham lugng Beta earoten cao, dang ehu y nhat la: ea rot, rau den, xoai, dua hau, du dii chin, ca ehua, gac.... Caroten khi vao ca the se duge ehuyen thanh vitamin A.
Nhung theo cac nghien eim gan day khbng phai luc nao caroten eiing chuyen dugc thanh vitamin A va ti le chuyen dbi nay khbng cao.
2. Bo sung vitamin A lieu cao cho tre: tre hi 6-36 thang duge uong bb sung vien nang vitamin A lieu cao. Vbi tre tren 12 thang den 36 thang ubng bb sung vien nang loai 200.000 don vi qube te (dvqt) mbi nam 2 lan. Vbi tre dubi 12 thang ubng bb sung vien nang loai 100.000 dvqt . Doi vbi ba me sau de trong vbng mbt thang can duge bo sung vi- taminA lieu eao mbt lieu 200.000 dvqt. Tre dubi 5 tubi khi bi tieu ehay, viem dubng hb hap, len sbi can dugc ubng mbt lieu vitamin A lieu cao.
3. Tang cuong vitamin A trong mot sb thuc pham:
nhieu nubc tren the gibi va trong khu vyc chau A
da ap dyng tang eubng vitamin A vao mbt sb thiic an nhu: ma Macgarin, bgt siia gay, dubng.... Viet Nam eiing bit da bat dau nghien eiiu thir nghiem tang cubng vitamin A vao thyc pham.
4. Phat hien va dieu trj tre khb mat: tre cb bieu hien khb mat do thieu vitamin A can phai dugc phat hien va dieu tri nhanh ehbng, kip thbi. Tat ea eae trubng hgp mac benh tii' quang ga, khb ket mac, vet Bitot den khb loet giac mac deu dugc cap tbc dieu tri theo phac db cua Tb ehire Y te The gibi nhu sau:
- Ngay lap tiie cho ubng 200.000 dvqt.
- Ngay hom sau ubng tiep 200.000 dvqt.
- Mbt tuan sau ubng nbt 200.000 dvqt.
Tre dubi 12 thang diing nira lieu tren (mbi lin ubng 100.000 dvqt).
Nhu vay khi tre bj khb mat can dugc ubng du 03 vien vitamin A lieu cao trong phac do dieu tri.
Cling khbng nen ty y mua va sir dung vitamin A mbt each tiiy tien. Vitamin A la loai vitamin tan trong chat beo khi thira se tieh Iiiy va gay ngb dbc cho ca the vbi cac bieu hien dau dau, met mbi, bubn nbn, rung tbe, rbi loan kinh nguyet b ngubi Ibn; met moi, cham tang can, tang ap lye sg nao (thbp phbng eang, nao ung thuy), dau xuong b tre em.
TAI LIEU THAM KHAO
1. Hd Huy Khdi Tir Gidy. "Cdc benh thieu dinh duong vd sire khoe cdng ddng d Viet Nam. NXB Y hgc, 1994.
2. Hd Huy Khdi, Tir Gidy. "Dinh dirdng hgp li vdi sire khoi ". NXB Y hgc, 1994.
3. Thomas V.Chacko, Yegna S.Sivan. "Vitamin A, Prophylaxis and Anemia control program". Sight and life magazine issue, NO 3/2008: tr 28 - 36.
4. Donalds.McLaren, Worthing. UK. "Multipe Micronutrients and Hidden hunger". Sight and life maga- zine issue, N03/2008: tr6-12. .
5. Leal Tory, Rorymar Tania, Ortega Pablo, Amaya Daysi. "High level ofinterferol gama in Adolescents with Vitamin A deficiency". Sight and life magazine issue, N02/2007: tr 13 - 15.
6. Johannes von Lintig. "The colourful world of Carotenoid (pre - Vitamin A) metabolism ". Sight and life magazine issue, N02/2007: tr 6- 12.
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