微生态制剂防治新生儿坏死性小肠结肠炎病例对照研究

Role of probiotics in the prevention of neonatal necrotizing enterocolitis: a case-control study

摘要:

目的：探讨新生儿坏死性小肠结肠炎(NEC)的危险因素及应用微生态制剂(培菲康)预防NEC发生的有效性。方法：对2002年1月至2005年5月住院治疗的2528例新生儿分为微生态制剂预防组与非预防组,观察两组NEC的发病率;以确诊NEC的患儿为病例组,非NEC新生儿为对照组进行病例对照研究。结果：预防组1182例中6例诊断为NEC,发病率0.51%;非预防组1346例中19例发生NEC,发病率为1.41%,两组差异具有显著性(P<0.05)。条件Logistic回归分析提示:胎龄、新生儿缺氧缺血性脑病、败血症及病情危重程度是危险因素;微生态制剂的应用是保护因素。结论：避免NEC的危险因素,预防性应用微生态制剂能够降低NEC发病率。

Abstract:

OBJECTIVE: To assess the role of probiotics in the prevention of neonatal necrotizing enterocolitis (NEC) and to investigate the risk factors for NEC. METHODS: A total of 2 528 hospitalized neonates between January 2002 and May 2005 were assigned into either receiving prophylactic use of probiotics bifoco (Prevention group, n=1 182) or without probiotics supplementation (Control group, n=1 346). The incidence of NEC was compared between the two groups. The risk factors for NEC were investigated by conditional logistic regression multifactorial analysis. RESULTS: There were 19 cases of NEC in the Control group (1.41%), but only 6 cases in the Prevention group (0.51%) (P<0.05). Gestational age (OR=5.521), hypoxic-ischemic encephalopathy (OR=3.887), specticemia (OR=4.854) and critical illness scores (OR=5.989) were the risk factors for NEC, while the prophylactic use of probiotics was an independent protective factor for NEC (OR=0.255). CONCLUSIONS: The prophylactic use of probiotics may reduce the incidence of NEC in neonates.