Serce Pehlevan Ozge, Benzer Derya, Gursoy Tugba, Karatekin Guner, Ovali Fahri
Neonatology Unit, Zeynep Kamil Maternity and Children's Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Neonatology Unit, Koc University School of Medicine, Istanbul, Turkey.
Clin Exp Pediatr. 2020 Jun;63(6):226-231. doi: 10.3345/cep.2019.00381. Epub 2020 Feb 5.
Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.
We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates.
Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death.
Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019).
The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.
益生菌和益生元对宿主有菌株特异性作用。合生元是益生菌和益生元的混合物，有人提出其对宿主的有益作用比单独使用任何一种成分都要大。
我们进行了一项随机对照试验，以研究乳酸杆菌和双歧杆菌与低聚糖及乳铁蛋白联合使用对极低出生体重儿坏死性小肠结肠炎（NEC）或败血症发生发展的影响。
纳入孕周≤32周且出生体重≤1500g的新生儿。研究组接受合生元和乳铁蛋白的联合制剂，而对照组从首次喂养开始至出院，接受1mL蒸馏水作为安慰剂。观察指标为NEC≥2期或晚发性血培养证实的败血症的发生率，以及NEC≥2期或死亡的发生率。
研究组（n=104）和对照组（n=104）的平均出生体重和孕周分别为1197±235g对1151±269g，以及29±1.9周对28±2.2周（P>0.05）。研究组和对照组之间，NEC≥2期或死亡的发生率，以及NEC≥2期或晚发性血培养证实的败血症的发生率均无差异（5.8%对5.9%，P=1；26%对21.2%，P=0.51）。唯一显著的差异是NEC各阶段的发生率（1.9%对10.6%，P=0.019）。
合生元和乳铁蛋白联合使用并未降低NEC的严重程度、败血症发生率或死亡率。
