鼠李糖乳杆菌 DSM 17938 对早产儿的影响：一项双盲随机对照研究。
Effects of Lactobacillus reuteri DSM 17938 in preterm infants: a double-blinded randomized controlled study.
机构信息
Department of Neonatology, Shengjing Hospital, China Medical University, Shenyang, China.
出版信息
Ital J Pediatr. 2019 Nov 9;45(1):140. doi: 10.1186/s13052-019-0716-9.
BACKGROUND
Preterm infants have immature gastrointestinal tracts and poor immunity. In this study, the effects of Lactobacillus reuteri DSM 17938 first on early feeding tolerance, growth, and second on infection prevention in preterm infants were evaluated.
METHODS
One hundred fourteen formula-fed preterm infants with a gestational age between 30 weeks and 37 weeks, and a birth weight between 1500 and 2000 g were enrolled; 57 in the intervention and 57 in the control group:the intervention group was given a dose of 1 × 10 colony-forming units (5 drops) of L. reuteri DSM 17938 once daily, beginning with the first feeding until discharge. The control group did not receive probiotics. Early feeding tolerance (as time to full enterla feeding and number of reflux), growth, incidences of sepsis, localized infection, NEC, and adverse effects were recorded for both groups.
RESULTS
The number of Daily reflux episodes (times/d) was lower (2.18 ± 0.83 vs. 3.77 ± 0.66, P < 0.01) and time to full enteral feedings (120 mL/kg/d) (9.95 ± 2.46 d vs. 13.80 ± 3.47 d, P < 0.05) was shorter in the intervention group. Average daily weight gain (14.55 ± 3.07 g/d vs. 10.12 ± 2.80 g/d), head circumference increas e(0.0760 ± 0.0157 cm/d vs. 0.0681 ± 0.0108 cm/d), and body length increase (0.1878 ± 0.0151 cm/d vs. 0.1756 ± 0.0166 cm/d) of the intervention group were higher (P < 0.01). There were no significant differences in the incidences of sepsis (4.44% vs. 8.33%), localized infection (6.67% vs. 8.33%), or NEC (2.22% vs. 10.42%) between the 2 groups (P > 0.05). The number of daily defecations (times/d) in the intervention group was higher (3.08 ± 0.33 vs. 2.29 ± 0.20, P < 0.01) and the length of hospital stay was shorter than that in the control group (20.60 ± 5.36 d vs. 23.75 ± 8.57 d, P < 0.05). No adverse effects were noted among the infants receiving L. reuteri.
CONCLUSION
L. reuteri may be an useful tool in improving early feeding tolerance in preterm infants, promoting growth, increasing the frequency of defecation, and shortening the length of hospital stay.
TRIAL REGISTRATION
ChiCTR, ChiCTR1900025590. Registered 1 February 2019- Retrospectively registered, http://www.chictr.org.cn/listbycreater.aspx.
背景
早产儿的胃肠道不成熟，免疫力差。本研究旨在评估罗特氏乳杆菌 DSM 17938 对早产儿早期喂养耐受、生长及感染预防的影响。
方法
本研究纳入 114 例胎龄 30 周至 37 周、出生体重 1500 至 2000 克的配方奶喂养早产儿，随机分为干预组（n=57）和对照组（n=57）。干预组从首次喂养开始给予 1×10 菌落形成单位（5 滴）的罗特氏乳杆菌 DSM 17938，每日 1 次，直至出院。对照组未给予益生菌。记录两组早产儿的早期喂养耐受（如完全肠内喂养的时间和反流次数）、生长情况、败血症、局部感染、NEC 和不良反应的发生率。
结果
干预组的每日反流次数（次/d）较低（2.18±0.83 比 3.77±0.66，P<0.01），完全肠内喂养的时间（120mL/kg/d）较短（9.95±2.46 天比 13.80±3.47 天，P<0.05）。干预组的平均日体重增加量（14.55±3.07 g/d 比 10.12±2.80 g/d）、头围增加量（0.0760±0.0157 cm/d 比 0.0681±0.0108 cm/d）和身长增加量（0.1878±0.0151 cm/d 比 0.1756±0.0166 cm/d）较高（P<0.01）。两组败血症（4.44%比 8.33%）、局部感染（6.67%比 8.33%）和 NEC（2.22%比 10.42%）的发生率差异无统计学意义（P>0.05）。干预组的每日排便次数（次/d）较高（3.08±0.33 比 2.29±0.20，P<0.01），住院时间较短（20.60±5.36 天比 23.75±8.57 天，P<0.05）。接受罗特氏乳杆菌的婴儿均未出现不良反应。
结论
罗特氏乳杆菌可能是改善早产儿早期喂养耐受、促进生长、增加排便频率、缩短住院时间的有效工具。
临床试验注册
ChiCTR，ChiCTR1900025590。注册日期：2019 年 2 月 1 日。- 回顾性注册，http://www.chictr.org.cn/listbycreater.aspx。
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