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益生菌与安慰剂:预防早产儿坏死性小肠结肠炎

Probiotics vs. Placebo: Preventing Necrotizing Enterocolitis in a Premature Infant.

作者信息

Ullah Sami, Khan Inayatullah, Lnu Ayesha, Ullah Khan Jabran, Syed Annam, Shafiq Fatima, Khan Muhammad, Khan Fahad R

机构信息

Pediatric Medicine, Lady Reading Hospital Medical Teaching Institute, Peshawar, PAK.

Pediatric Medicine, Peshawar Institute of Medical Sciences, Peshawar, PAK.

出版信息

Cureus. 2024 Sep 7;16(9):e68848. doi: 10.7759/cureus.68848. eCollection 2024 Sep.

DOI:10.7759/cureus.68848
PMID:39376813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11456835/
Abstract

BACKGROUND

Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition primarily affecting preterm newborns, leading to significant morbidity and mortality.

OBJECTIVE

This prospective cohort study aimed to evaluate the effectiveness of probiotics in preventing NEC in premature infants. Secondary objectives included assessing the impact on mortality, late-onset sepsis, duration of hospital stay, and weight gain.

METHODS

The study was conducted at Lady Reading Hospital Medical Teaching Institute, Peshawar, from April 1, 2023, to March 31, 2024, involving 102 preterm infants. Participants were randomly assigned to receive daily oral probiotics (Lactobacillus and Bifidobacterium species) or a placebo.

RESULTS

The incidence of NEC was significantly lower in the probiotic group (7.8%) compared to the placebo group (21.6%; p = 0.04). The probiotic group also showed significant reductions in late-onset sepsis (13.7% vs. 29.4%; p = 0.03), shorter hospital stays (42.5 vs. 48.1 days; p = 0.02), and greater weight gain (15.3 vs. 13.4 grams/day; p = 0.01).

CONCLUSION

These findings support the integration of probiotics into neonatal care, particularly in resource-limited settings.

摘要

背景

坏死性小肠结肠炎(NEC)是一种主要影响早产新生儿的严重胃肠道疾病,会导致显著的发病率和死亡率。

目的

这项前瞻性队列研究旨在评估益生菌对预防早产儿坏死性小肠结肠炎的有效性。次要目标包括评估对死亡率、晚发性败血症、住院时间和体重增加的影响。

方法

该研究于2023年4月1日至2024年3月31日在白沙瓦的莱迪·里德医院医学教学机构进行,涉及102名早产儿。参与者被随机分配接受每日口服益生菌(乳酸杆菌和双歧杆菌属)或安慰剂。

结果

益生菌组的坏死性小肠结肠炎发病率(7.8%)显著低于安慰剂组(21.6%;p = 0.04)。益生菌组的晚发性败血症也显著减少(13.7%对29.4%;p = 0.03),住院时间更短(42.5天对48.1天;p = 0.02),体重增加更多(15.3克/天对13.4克/天;p = 0.01)。

结论

这些发现支持将益生菌纳入新生儿护理,特别是在资源有限的环境中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77eb/11456835/38091a90a98d/cureus-0016-00000068848-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77eb/11456835/215565dc01ba/cureus-0016-00000068848-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77eb/11456835/38091a90a98d/cureus-0016-00000068848-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77eb/11456835/215565dc01ba/cureus-0016-00000068848-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77eb/11456835/38091a90a98d/cureus-0016-00000068848-i02.jpg

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本文引用的文献

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Probiotics to improve the gut microbiome in premature infants: are we there yet?益生菌改善早产儿肠道微生物组:我们做到了吗?
Gut Microbes. 2023 Jan-Dec;15(1):2201160. doi: 10.1080/19490976.2023.2201160.
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Probiotics for Preventing Necrotizing Enterocolitis in Preterm Infants: A Network Meta-Analysis.益生菌预防早产儿坏死性小肠结肠炎的网状 Meta 分析。
Nutrients. 2021 Jan 9;13(1):192. doi: 10.3390/nu13010192.
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Probiotics and necrotizing enterocolitis.益生菌与坏死性小肠结肠炎
Semin Pediatr Surg. 2018 Feb;27(1):39-46. doi: 10.1053/j.sempedsurg.2017.11.008. Epub 2017 Nov 6.
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Perinatal health services organization for preterm births: a multinational comparison.早产的围产期保健服务组织:一项跨国比较
J Perinatol. 2017 Jul;37(7):762-768. doi: 10.1038/jp.2017.45. Epub 2017 Apr 6.
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Surgical necrotizing enterocolitis.外科坏死性小肠结肠炎
Semin Perinatol. 2017 Feb;41(1):70-79. doi: 10.1053/j.semperi.2016.09.020. Epub 2016 Nov 8.
6
A randomised controlled trial of the probiotic Bifidobacterium breve BBG-001 in preterm babies to prevent sepsis, necrotising enterocolitis and death: the Probiotics in Preterm infantS (PiPS) trial.益生菌短双歧杆菌BBG-001预防早产儿败血症、坏死性小肠结肠炎和死亡的随机对照试验:早产儿益生菌(PiPS)试验
Health Technol Assess. 2016 Aug;20(66):1-194. doi: 10.3310/hta20660.
7
Probiotics for prevention of necrotizing enterocolitis in preterm infants.益生菌用于预防早产儿坏死性小肠结肠炎
Cochrane Database Syst Rev. 2014 Apr 10(4):CD005496. doi: 10.1002/14651858.CD005496.pub4.
8
Probiotic effects on late-onset sepsis in very preterm infants: a randomized controlled trial.益生菌对极早产儿晚发性败血症的影响:一项随机对照试验。
Pediatrics. 2013 Dec;132(6):1055-62. doi: 10.1542/peds.2013-1339. Epub 2013 Nov 18.
9
Probiotic supplement reduces risk of necrotizing enterocolitis and mortality in preterm very low-birth-weight infants: an updated meta-analysis of 20 randomized, controlled trials.益生菌补充剂可降低极低出生体重早产儿患坏死性小肠结肠炎和死亡的风险:20 项随机对照试验的更新荟萃分析。
J Pediatr Surg. 2012 Jan;47(1):241-8. doi: 10.1016/j.jpedsurg.2011.09.064.
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Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants.口服乳铁蛋白预防早产儿败血症和坏死性小肠结肠炎
Cochrane Database Syst Rev. 2011 Oct 5(10):CD007137. doi: 10.1002/14651858.CD007137.pub3.