乳酸杆菌预防早产儿坏死性小肠结肠炎的安全性和有效性。
Safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis in preterm infants.
机构信息
Neonatal Intensive Care Unit, Zhengzhou Key Laboratory of Newborn Disease Research, Department of NICU, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450018, China.
Neonatal Intensive Care Unit, Zhengzhou Key Laboratory of Newborn Disease Research, Department of Neonatal Surgery, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450018, China.
出版信息
Int J Surg. 2020 Apr;76:79-87. doi: 10.1016/j.ijsu.2020.02.031. Epub 2020 Feb 26.
AIM
To evaluate the safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis (NEC) in preterm infants.
METHODS
We searched the Cochrane Library, PubMed, EMBASE, and Web of Science databases from inception to September 2019. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to compare outcomes. We also performed a subgroup analysis of the incidence of NEC. Moreover, a sensitivity analysis was performed to examine the stability of the results. A Begg funnel plot was generated to detect publication bias. Two reviewers assessed trial quality and extracted data independently. This work has been reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the Assessing the Methodological Quality of Systematic Reviews guidelines. Statistical analysis was performed using standard procedures in Review Manager 5.2 software.
RESULTS
Twenty-three randomized, placebo-controlled studies (N = 4686 participants) were included in this analysis. Comparing the Lactobacillus and control groups, a significant reduction was found in the incidence of NEC (RR 0.34, 95% CI 0.25-0.46; P < 0.00001) and death (RR 0.48, 95% CI 0.36-0.64; P < 0.00001). No significant difference in the incidence of sepsis was found between the Lactobacillus and placebo groups (RR 0.90, 95% CI 0.72-1.12; P = 0.34).
CONCLUSIONS
Lactobacillus is safe and can prevent necrotizing enterocolitis in preterm infants.
目的
评估乳酸杆菌预防早产儿坏死性小肠结肠炎（NEC）的安全性和有效性。
方法
我们检索了 Cochrane 图书馆、PubMed、EMBASE 和 Web of Science 数据库，检索时间从建库至 2019 年 9 月。采用风险比（RR）及其 95%置信区间（CI）比较结局。我们还对 NEC 的发生率进行了亚组分析。此外，还进行了敏感性分析以检验结果的稳定性。采用 Begg 漏斗图来检测发表偏倚。两位审查员独立评估试验质量并提取数据。本研究按照系统评价和荟萃分析的首选报告项目以及系统评价方法学质量评估指南进行报告。采用 Review Manager 5.2 软件进行统计分析。
结果
本分析纳入了 23 项随机、安慰剂对照研究（N = 4686 名参与者）。与安慰剂组相比，乳酸杆菌组 NEC 的发生率显著降低（RR 0.34，95%CI 0.25-0.46；P < 0.00001），死亡率也显著降低（RR 0.48，95%CI 0.36-0.64；P < 0.00001）。乳酸杆菌组与安慰剂组之间败血症的发生率无显著差异（RR 0.90，95%CI 0.72-1.12；P = 0.34）。
结论
乳酸杆菌是安全的，并能预防早产儿坏死性小肠结肠炎。
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