益生菌预防极低出生体重儿迟发型败血症的Meta分析

Efficacy of probiotics in preventing late-onset sepsis in very low birth weight infants: a Meta analysis

摘要:

目的 评估益生菌预防极低出生体重儿迟发型败血症（late-onset sepsis，LOS）的有效性。方法 检索PubMed、Web of Science、Cochrane Library、万方数据库、中国知网、中国生物医学文献数据库等数据库中关于益生菌预防极低出生体重儿LOS的临床随机对照试验。LOS类型包括临床败血症和确定败血症。使用RevMan 5.4软件进行Meta分析。结果 最终纳入31篇文献（益生菌组3 490例，对照组3 376例）。Meta分析显示，与对照组相比，益生菌组临床LOS的发生风险较低（RR=0.79，95%CI：0.66~0.94，P=0.009）；益生菌组临床/确定LOS的发生风险较低（RR=0.79，95%CI：0.67~0.94，P=0.007）；益生菌组中纯母乳喂养者确定LOS的发生风险较低（RR=0.77，95%CI：0.62~0.96，P=0.02）。结论 当前证据表明，益生菌可降低极低出生体重儿临床LOS和临床/确定LOS的发生风险，以及纯母乳喂养的极低出生体重儿确定LOS的发生风险。

Abstract:

Objective To study the efficacy of probiotics in preventing late-onset sepsis (LOS) in very low birth weight (VLBW) infants. Methods Databases including PubMed, Web of Science, Cochrane Library, Wanfang Data, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database were searched for randomized controlled trials (RCTs) of probiotics in preventing LOS in VLBW infants. LOS was classified as clinical LOS and confirmed LOS. RevMan 5.4 was used to perform the Meta analysis. Results A total of 31 RCTs were included, with 3 490 VLBW infants in the probiotics group and 3 376 VLBW infants in the control group. The Meta analysis showed that compared with the control group, the probiotics group had significantly lower risks of clinical LOS (RR=0.79, 95%CI:0.66-0.94, P=0.009) and clinical/confirmed LOS (RR=0.79, 95% CI:0.67-0.94, P=0.007). In the probiotics group, the infants receiving exclusive breastfeeding had a significantly lower risk of confirmed LOS (RR=0.77, 95%CI:0.62-0.96, P=0.02). Conclusions Current evidence indicates that probiotics may reduce the risk of clinical LOS and clinical/confirmed LOS in VLBW infants, and the risk of confirmed LOS in VLBW infants who are exclusively breastfed.