益生菌对坏死性小肠结肠炎、败血症、脑室出血、死亡率、住院时间和极低出生体重儿体重增加的影响：一项荟萃分析。
Effects of Probiotics on Necrotizing Enterocolitis, Sepsis, Intraventricular Hemorrhage, Mortality, Length of Hospital Stay, and Weight Gain in Very Preterm Infants: A Meta-Analysis.
机构信息
School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
Menzies Health Institute, Gold Coast, Queensland, Australia.
出版信息
Adv Nutr. 2017 Sep 15;8(5):749-763. doi: 10.3945/an.116.014605. Print 2017 Sep.
Probiotics are increasingly used as a supplement to prevent adverse health outcomes in preterm infants. We conducted a systematic review, meta-analysis, and subgroup analysis of findings from randomized controlled trials (RCTs) to assess the magnitude of the effect of the probiotics on health outcomes among very-low-birth-weight (VLBW) infants. Relevant articles from January 2003 to June 2017 were selected from a broad range of databases, including Medline, PubMed, Scopus, and Embase. Studies were included if they used an RCT design, involved a VLBW infant (birthweight <1500 g or gestational age <32 wk) population, included a probiotic intervention group, measured necrotizing enterocolitis (NEC) as a primary outcome, and measured sepsis, mortality, length of hospital stay, weight gain, and intraventricular hemorrhage (IVH) as additional outcomes. The initial database search yielded 132 potentially relevant articles and 32 ( = 8998 infants) RCTs were included in the final meta-analysis. Subgroup analysis was used to evaluate the effects of the moderators on the outcome variables. In the probiotics group, it was found that NEC was reduced by 37% (95% CI: 0.51%, 0.78%), sepsis by 37% (95% CI: 0.72%, 0.97%), mortality by 20% (95% CI: 0.67%, 0.95%), and length of hospital stay by 3.77 d (95% CI: -5.94, -1.60 d). These findings were all significant when compared with the control group. There was inconsistent use of strain types among some of the studies. The results indicate that probiotic consumption can significantly reduce the risk of developing medical complications associated with NEC and sepsis, reduce mortality and length of hospital stay, and promote weight gain in VLBW infants. Probiotics are more effective when taken in breast milk and formula form, consumed for <6 wk, administered with a dosage of <10 CFU/d, and include multiple strains. Probiotics are not effective in reducing the incidence of IVH in VLBW infants.
益生菌越来越多地被用作补充剂，以预防早产儿的不良健康后果。我们进行了系统评价、荟萃分析和随机对照试验（RCT）结果的亚组分析，以评估益生菌对极低出生体重（VLBW）婴儿健康结果的影响程度。从 2003 年 1 月至 2017 年 6 月，从广泛的数据库中选择了相关文章，包括 Medline、PubMed、Scopus 和 Embase。如果研究使用 RCT 设计，涉及 VLBW 婴儿（出生体重 <1500 克或胎龄 <32 周）人群，包括益生菌干预组，将坏死性小肠结肠炎（NEC）作为主要结局，并测量败血症、死亡率、住院时间、体重增加和脑室出血（IVH）作为额外结局，则纳入研究。最初的数据库搜索产生了 132 篇潜在相关文章，最终荟萃分析纳入了 32 项（=8998 名婴儿）RCT。使用亚组分析评估了调节变量对结局变量的影响。在益生菌组中，发现 NEC 减少了 37%（95%CI：0.51%，0.78%），败血症减少了 37%（95%CI：0.72%，0.97%），死亡率降低了 20%（95%CI：0.67%，0.95%），住院时间缩短了 3.77 天（95%CI：-5.94，-1.60 天）。与对照组相比，这些发现均具有统计学意义。一些研究中使用的菌株类型不一致。结果表明，益生菌的摄入可以显著降低与 NEC 和败血症相关的医疗并发症的风险，降低死亡率和住院时间，促进 VLBW 婴儿的体重增加。在母乳喂养和配方奶中摄入益生菌、使用时间 <6 周、剂量 <10CFU/d、包含多种菌株时，益生菌的效果更显著。益生菌不能降低 VLBW 婴儿脑室出血的发生率。
Zotero 插件