益生菌补充与早产儿晚发型败血症：一项荟萃分析。
Probiotic Supplementation and Late-Onset Sepsis in Preterm Infants: A Meta-analysis.
机构信息
Neonatal ICU, King Edward Memorial Hospital for Women, Perth, Western Australia; Neonatal ICU, Princess Margaret Hospital for Children, Perth, Western Australia; Centre for Neonatal Research and Education, School of Pediatrics and Child Health, University of Western Australia, Perth, Western Australia;
Neonatal ICU, Nepean Hospital, Kingswood, NSW, Australia; and Sydney Medical School, Nepean, University of Sydney, Australia.
出版信息
Pediatrics. 2016 Mar;137(3):e20153684. doi: 10.1542/peds.2015-3684. Epub 2016 Feb 12.
CONTEXT
Late-onset sepsis (LOS) is a major cause of mortality and morbidity in preterm infants. Despite various preventive measures, its incidence continues to remain high, hence the urgent need for additional approaches. One such potential strategy is supplementation with probiotics. The updated Cochrane Review (2014) did not find benefits of probiotics in reducing the risk of LOS in preterm infants (19 studies, N = 5338). Currently there are >30 randomized controlled trials (RCTs) of probiotics in preterm infants that have reported on LOS.
OBJECTIVES
To conduct a systematic review including all relevant RCTs.
DATA SOURCES
PubMed, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and E-abstracts from the Pediatric Academic Society meetings and other pediatric and neonatal conference proceedings were searched in June and August 2015.
STUDY SELECTION
RCTs comparing probiotics versus placebo/no probiotic were included.
DATA EXTRACTION
Relevant data were extracted independently by 3 reviewers.
RESULTS
Pooled results from 37 RCTs (N = 9416) using fixed effects model meta analysis showed that probiotics significantly decreased the risk of LOS (675/4852 [13.9%] vs 744/4564 [16.3%]; relative risk, 0.86; 95% confidence interval, 0.78-0.94; P = .0007; I(2) = 35%; number needed to treat, 44). The results were significant even after excluding studies with high risk of bias.
CONCLUSIONS
Probiotic supplementation reduces the risk of LOS in preterm infants.
背景
晚发型败血症（LOS）是早产儿死亡和发病的主要原因。尽管采取了各种预防措施，但其发病率仍然居高不下，因此迫切需要额外的方法。一种潜在的策略是补充益生菌。更新的 Cochrane 综述（2014 年）发现益生菌不能降低早产儿 LOS 的风险（19 项研究，N = 5338）。目前，有超过 30 项益生菌治疗早产儿 LOS 的随机对照试验（RCT）已发表。
目的
进行一项系统综述，包括所有相关的 RCT。
数据来源
2015 年 6 月和 8 月，检索了 PubMed、Embase、Cochrane 对照试验中心注册库、护理和联合健康文献累积索引、儿科学术协会会议的电子摘要以及其他儿科和新生儿会议论文集。
研究选择
纳入比较益生菌与安慰剂/无益生菌的 RCT。
数据提取
由 3 位评审员独立提取相关数据。
结果
使用固定效应模型荟萃分析，对 37 项 RCT（N = 9416）的汇总结果显示，益生菌显著降低 LOS 的风险（675/4852[13.9%]vs744/4564[16.3%]；相对风险，0.86；95%置信区间，0.78-0.94；P =.0007；I(2) = 35%；需要治疗的人数，44）。即使排除高偏倚风险的研究，结果仍然显著。
结论
益生菌补充可降低早产儿 LOS 的风险。
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