Neonatal Intensive Care Unit, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.
Am J Clin Nutr. 2011 Jan;93(1):81-6. doi: 10.3945/ajcn.2010.29799. Epub 2010 Oct 27.
Probiotics are used for the prevention of necrotizing enterocolitis (NEC) because of their positive effects on intestinal motor function, modulation of inflammatory response, and mucosal barrier function.
The objective was to assess whether the combined use of Lactobacillus casei and Bifidobacterium breve may prevent the occurrence of NEC stage ≥ 2 by the criteria of Bell in very-low-birth-weight preterm infants.
A double-blind, randomized, controlled clinical trial was conducted in 231 preterm infants weighing from 750 to 1499 g at birth. The intervention group was composed of 119 infants who received human milk with probiotic supplementation (B. breve and L. casei) and a control group of 112 infants who received human milk containing no probiotics. The primary outcome was the occurrence of NEC stage ≥ 2 as defined by Bell's modified criteria.
Four confirmed cases of NEC stage ≥ 2 by Bell's criteria occurred only in the control group.
Oral supplementation of B. breve and L. casei reduced the occurrence of NEC (Bell's stage ≥ 2). It was considered that an improvement in intestinal motility might have contributed to this result. This trial was registered at www.isrctin.org as number 67165178 (International Standard Randomized Controlled Trial).
由于益生菌对肠道运动功能、炎症反应调节和黏膜屏障功能具有积极作用，因此被用于预防坏死性小肠结肠炎（NEC）。
本研究旨在评估鼠李糖乳杆菌和短双歧杆菌联合使用是否能通过 Bell 标准预防极低出生体重早产儿发生 2 级及以上 NEC。
对 231 例出生体重为 750 至 1499g 的早产儿进行了一项双盲、随机、对照临床试验。干预组由 119 例接受含益生菌（短双歧杆菌和鼠李糖乳杆菌）补充人乳的婴儿组成，对照组由 112 例接受不含益生菌的人乳的婴儿组成。主要结局是采用 Bell 改良标准定义的 2 级及以上 NEC 的发生情况。
Bell 标准确诊的 2 级及以上 NEC 仅发生在对照组，共有 4 例。
口服补充短双歧杆菌和鼠李糖乳杆菌可降低 NEC（Bell 2 级及以上）的发生风险。这可能与改善肠道蠕动有关。本试验已在 www.isrctn.org 注册，编号为 67165178（国际标准随机对照试验）。
