益生菌预防低出生体质量儿坏死性小肠结肠炎效果的Meta分析  

Meta-Analysis on Efficacy of Probiotics in the Prevention of Necrotizing Enterocolitis in Infants with Low Birth Weight

作　　者：徐鑫苑 龚放[1] 谢波[1] Xu Xinyuan;Gong Fang;Xie Bo(Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院,重庆402160

出　　处：《儿科药学杂志》2023年第6期39-46,共8页Journal of Pediatric Pharmacy

摘　　要：目的:比较不同益生菌和安慰剂预防低出生体质量儿坏死性小肠结肠炎(NEC)的效果,初步确定推荐预防方案。方法:检索中国知网、万方、维普、PubMed、Web of Science、the Cochrane Library、OVID、Medline、EMBase等数据库,筛选出建库至2022年7月31日发表的益生菌和安慰剂预防NEC相关的随机对照试验(RCT)。采用Cochrane协作网偏倚风险评估工具评估RCT质量,RevMan 5.3软件进行Meta分析。结果:纳入43项RCT,共有10247例低出生体质量儿。Meta分析结果显示,与安慰剂组相比,益生菌组NEC发生率[OR=0.55,95%CI(0.46,0.66)]、病死率[OR=0.66,95%CI(0.56,0.79)]均降低(P均<0.01)。亚组分析结果显示,与安慰剂组相比,益生菌混合制剂组NEC发生率[OR=0.41,95%CI(0.29,0.57)]、病死率[OR=0.51,95%CI(0.40,0.66)]降低(P均<0.01),且降低幅度大于益生菌单一制剂组。结论:益生菌预防性应用可降低低出生体质量儿NEC的发生率和病死率,且混合制剂效果优于单一制剂,推荐在益生菌预防NEC方案中采用混合制剂。Objective:To compare the efficacy of different probiotics and placebo in the prevention of necrotizing enterocolitis(NEC)in infants with low birth weight,so as to preliminary formulate recommendations for prevention.Methods:CNKI,Wanfang,VIP,PubMed,Web of Science,the Cochrane Library,OVID,Medline,EMBase databases were retrieved to collect the randomized controlled trials(RCT)of probiotics and placebo in the prevention of NEC.The retrieval time was from the establishment of the database to Jul.31 st,2022.The quality of the included RCT was evaluated by the risk of bias assessment tool of Cochrane Collaboration Network.Metaanalysis was carried out by using RevMan 5.3 software.Results:There were 43 RCT,including 10,247 infants with low birth weight.Compared with placebo group,the incidence of NEC(OR=0.55,95%CI from 0.46 to 0.66)and mortality(OR=0.66,95%CI from 0.56 to 0.79)in the probiotics group decreased(P<0.01).According to subgroup analysis,compared with placebo group,the incidence of NEC(OR=0.41,95%CI from 0.29 to 0.57)and mortality(OR=0.51,95%CI from 0.40 to 0.66)in the probiotics combination group decreased(P<0.01),and the reduction was greater than that in the single probiotics group.Conclusion:Prophylactic use of probiotics can reduce the incidence and mortality of NEC in infants with low birth weight,and the effect of mixed preparation is better than that of single preparation,it is recommended to use mixed preparation in probiotics in the prevention of NEC.

关 键 词：坏死性小肠结肠炎 益生菌 低出生体质量儿 随机对照试验 

分 类 号：R722.1[医药卫生—儿科]