Objective    To assess the clinical efficacy of supplemental administration of vitamin A and E

zinc

and selenite for neonatal pneumonia by evaluating their effects on biochemical and immune indexes.     Methods    A total of 150 matched child (age30 d) with neonatal pneumonia were recruited in this randomized

double-blind

placebo-controlled

7-day clinical trial. The cases were randomly and equally divided into 3 groups

that is

VA group (4 500 IU vitamin A once per day)

multinutrient group (daily 4 500 IU vitamin A

20 mg vitamin E

9 mg zinc

and 20  g selenite) and placebo group (daily 1 ml normal sodium). Routine treatment for pneumonia were given to all patients. Before and 7 d after supplementation

their serum contents of vitamin A

retinol binding protein (RBP)

IgM and malondialdehyde (MOD) were tested by HPLC

ELISA

immunoturbidimetry

and spectrophotometry with thiobarbituric acid respectively. Vitamin A deficiency (VAD) was evaluated according to WHO standard.     Results    Only 111 neonates had all clinical data with VA group 37 children

multinutrient group 39

and placebo group 35

and 65 patients had clinical data and laboratory indexes

including 23 in VA group

24 in multinutrient group and 18 in placebo group. VA group and multinutrient group had a shorter recovery time in signs and symptoms than placebo group (P0.01)

but no difference was seen in these 2 supplementation groups. Among the 65 patients

the prevalence rates of serious VAD

VAD

marginal form VAD were 13.8%

26.2% and 36.9% respectively before supplementation

and the serum VA content in 2 supplementation groups were significantly higher after supplementation than before (P0.01)

but no such difference was seen in placebo group. After supplementation

there was no significant difference in serum RBP concentration in VA and multinutrient groups

but that of placebo group was obviously increased (P0.01). The serum IgM and MDA were significantly declined in VA group and multinutrient group (P0.05)

no change was seen in placebo group. No toxic symptom was observed in period of hospitalization.     Conclusion    Daily low-dose oral nutrient supplementation significantly promotes the release of clinical symptoms

enhances the immune function and antioxidation capacity for neonatal pneumonia

but no difference is seen between single oral administration of vitamin A and of vitamin A

E

zinc and selenite

which may be due to our short observation time. The oral multinutrient administration is safe and feasible for neonate on clinical treatment.