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早产儿晚发性败血症补锌治疗:有益吗?

Zinc Supplementation in Preterm Neonates with Late-Onset Sepsis: Is It Beneficial?

机构信息

Faculty of Medicine, Tanta University, Tanta, Egypt.

Faculty of Pharmacy, Tanta University, Tanta, Egypt.

出版信息

Am J Perinatol. 2022 Jul;39(10):1097-1103. doi: 10.1055/s-0040-1721659. Epub 2020 Dec 7.

Abstract

OBJECTIVE

Neonatal sepsis (NS) is a serious neonatal disease. The aim of this study was to detect the role of zinc (Zn) supplementation in preterm neonates with late-onset sepsis (LOS).

STUDY DESIGN

A prospective randomized clinical trial study which was done at Tanta University Hospital from August 2016 to March 2018 on 180 preterm neonates with LOS. The studied neonates were divided into two groups: group 1 (90 neonates), which received Zn and antibiotics, and group 2 (90 neonates), which received antibiotics and placebo. In group 1, the neonates received 1.4 mg elemental Zn/kg/d orally for 10 days. Sepsis score, C-reactive protein (CRP), and procalcitonin (PCT) were done for both groups.

RESULTS

As regards sepsis score, it showed that before beginning the treatment, there were 85 and 84 neonates who had high probable sepsis (HPS) in intervention and control groups, respectively, and this revealed nonstatistically significant difference (non-SSD) between both groups (-value is 0.756) and after 10 days of treatment, there were 1 and 4 neonates who had HPS in intervention and control group, respectively, and this revealed SSD between both groups (-value is 0.045*). As regards CRP and PCT, the results showed that before beginning the treatment, the mean ± standard deviation (SD) of CRP and PCT were 39.4 ± 10.1 mg/L and 5.2 + 1.8 ng/mL, respectively, in intervention group, while it was 39.6 + 9.9 mg/L and 5.1 + 1.9 ng/mL, respectively, in control group and this revealed non-SSD between both groups (-value is 0.893 and 0.717, respectively) and after 10 days of treatment, the mean ± SD of CRP and PCT were 5.3 ± 1.8 mg/L and 0.39 ± 0.13 ng/mL, respectively, in intervention group and 6.1 + 2 mg/L and 0.61 + 0.22 ng/mL, respectively, in control group and this revealed SSD between both groups (-value is 0.008* and 0.044*, respectively).

CONCLUSION

Zn supplementation in preterm neonates with LOS is beneficial in improving the clinical and laboratory finding.

RECOMMENDATION

Zn supplementation for preterm neonates with LOS.

KEY POINTS

· NS is a serious neonatal disease.. · Preterm neonates are more liable to infections.. · Zn supplementation in preterm neonates with LOS is beneficial in improving the condition..

摘要

目的

新生儿败血症(NS)是一种严重的新生儿疾病。本研究旨在探讨锌(Zn)补充对早产儿晚发性败血症(LOS)的作用。

研究设计

这是一项前瞻性随机临床试验研究,于 2016 年 8 月至 2018 年 3 月在坦塔大学医院进行,共纳入 180 例 LOS 早产儿。将研究对象分为两组:第 1 组(90 例)接受 Zn 和抗生素治疗,第 2 组(90 例)接受抗生素和安慰剂治疗。第 1 组新生儿每天口服 1.4mg 元素 Zn/kg 治疗 10 天。对两组患儿均进行败血症评分、C 反应蛋白(CRP)和降钙素原(PCT)检测。

结果

就败血症评分而言,治疗前,干预组和对照组分别有 85 例和 84 例患儿有高度可能败血症(HPS),差异无统计学意义(-值为 0.756);治疗 10 天后,干预组和对照组分别有 1 例和 4 例患儿有 HPS,差异有统计学意义(-值为 0.045*)。就 CRP 和 PCT 而言,治疗前,干预组 CRP 和 PCT 的均值±标准差(SD)分别为 39.4±10.1mg/L 和 5.2+1.8ng/mL,对照组分别为 39.6±9.9mg/L 和 5.1+1.9ng/mL,差异无统计学意义(-值分别为 0.893 和 0.717);治疗 10 天后,干预组 CRP 和 PCT 的均值±SD 分别为 5.3±1.8mg/L 和 0.39±0.13ng/mL,对照组分别为 6.1+2mg/L 和 0.61+0.22ng/mL,差异有统计学意义(-值分别为 0.008和 0.044)。

结论

Zn 补充治疗 LOS 早产儿有益,可改善临床和实验室检查结果。

建议

对 LOS 早产儿进行 Zn 补充治疗。

重点提示

  1. NS 是一种严重的新生儿疾病。

  2. 早产儿更易发生感染。

  3. LOS 早产儿补锌治疗有益。

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