极低出生体质量儿人乳喂养与早产儿视网膜病变发病率关系的Meta分析  

Meta-analysis on relationship between human milk feeding and retinopathy of prematurity in very low birth weight infants

作　　者：门光国[1] 王丽丽 姜燕丽 吕勤[1] MEN Guangguo;WANG Lili;JIANG Yanli(Department of NICU,Ningbo Women and Children’s Hospital,Ningbo 315012,China;不详)

机构地区：[1]宁波市妇女儿童医院NICU,315012 [2]山东省东阿县人民医院儿科 [3]宁波市第七医院儿科

出　　处：《浙江医学》2019年第23期2501-2506,共6页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技项目（2019KY623）;浙江省公益性技术应用研究计划（2017C35010）

摘　　要：目的系统评价人乳喂养对极低出生体质量儿(VLBWI)早产儿视网膜病变(ROP)发病率的影响。方法利用万方、中国知网、PubMed、MEDLINE、EMBASE、CINAHL、Cochrane Central Register of Clinical Trials等数据库,检索1990年后发表的关于出生时胎龄≤28周和/或出生体质量≤1500g的VLBWI人乳喂养与ROP发病率关系的文献,研究设计包括纯人乳(EHM)与早产儿配方奶(EPTF)、部分人乳与EPTF、高剂量人乳与低剂量人乳喂养婴儿的ROP发病率比较,共有29篇文献纳入研究。结果2项随机试验、5项观察性研究分别报道了EHM与EPTF喂养ROP发病率比较的结果,差异均无统计学意义(均P>0.05);其中3项研究报道了EHM与EPTF喂养严重ROP发病率比较的结果,显示EHM喂养能降低严重ROP发病率(RR=0.22,RD=-0.08,OR=0.20,P<0.05)。6项观察性研究报道了部分人乳与EPTF喂养ROP发病率比较的结果,显示差异无统计学意义(P>0.05),其中3项研究报道了部分人乳与EPTF喂养严重ROP发病率比较的结果,差异亦无统计学意义(P>0.05)。4项随机试验报道了高剂量与低剂量人乳喂养ROP发病率比较的结果,显示差异无统计学意义(P>0.05);19项观察性研究报道了高剂量与低剂量人乳喂养ROP发病率比较的结果,显示高剂量人乳喂养能降低ROP发病率(RR=0.82,RD=-0.03,OR=0.75,P<0.05);其中13项研究报道了高剂量与低剂量人乳喂养严重ROP发病率比较的结果,显示高剂量人乳喂养能降低严重ROP发病率(RR=0.66,RD=-0.02,OR=0.64,P<0.05)。结论EHM或高剂量人乳喂养可能降低VLBWI发生ROP的风险。Objective To evaluate systematically the effects of human milk feeding on the incidence of retinopathy of prematurity(ROP)in very low birth weight infants(VLBWI).Methods Theliterature published after 1990 was searched from Wanfang,CNKI,PubMed,MEDLINE,EMBASE,CINAHL,Cochrane Central Register of Clinical Trials and other databases.The incidence of ROP in between VLBWIswith exclusive human milk(EHM)and exclusive preterm formula(EPTF)feeding,any human milk and EPTF feeding,high-dose human milk and low-dose human milk feeding was compared.A total of 29 studies were included for analysis.Results Two randomized trials and five observationstudies reported that by comparison of incidence of ROP between EHM and EPTF,the differences were not statistically significant(P>0.05);3 of these studies reported that EHM feeding reduced the incidence of severe ROP(RR=0.22,RD=-0.08,OR=0.20,P<0.05).Six observation studies reported the incidence of ROP between any human milk and EPTF feedingwas not significantly different(P>0.05);3 of which reported that the incidence of severe ROP was also not significantly different between any human milk and EPTF feeding(P>0.05).Four randomized trials reported that there was no significant difference in the incidence of ROP between high-dose human milk feeding and low-dose human milk feeding(P>0.05).Nineteen observation studies reported that high-dose human milk feeding reduced the incidence of ROP(RR=0.82,RD=-0.03,OR=0.75,P<0.05).Thirteen studies reported that compared with low-dose human milk feeding,high-dose human milk feeding reduced the incidence of severe ROP(RR=0.66,RD=-0.02,OR=0.64,P<0.05).Conclusion EHM or high-dose human milk feeding may reduce the risk of ROP in VLBWI.

关 键 词：早产儿 人乳 早产儿配方奶 早产儿视网膜病变 

分 类 号：R72[医药卫生—儿科]