预防性使用水解蛋白配方奶对早产儿胃肠道疾病及体格生长影响的Meta分析

Effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseasesand physical growth in preterm infants: a Meta analysis

摘要:

目的 系统评价预防性使用水解蛋白配方奶对早产儿胃肠道疾病及体格发育的影响。 方法 计算机检索中国知网、万方、维普、PubMed、Embase、Cochrane Library等数据库，纳入关于早产儿预防性使用水解蛋白配方奶对胃肠道疾病及体格生长影响的随机对照研究。使用RevMan 5.3软件对符合纳入标准的文献进行Meta分析。 结果 纳入7篇随机对照研究。Meta分析结果显示，与整蛋白配方奶相比，预防性使用水解蛋白配方奶能降低早产儿发生坏死性小肠结肠炎（RR=0.40，P=0.04）和喂养不耐受（RR=0.40，P=0.005）的风险，而对早产儿体重、身长和头围发育无明显影响（P>0.05）。 结论 与整蛋白配方奶相比，早产儿预防性使用水解蛋白配方奶可能可减少NEC和喂养不耐受的发生，并能满足体格发育的营养需求。但目前证据有限，该研究结果尚不能支持常规在早产儿群体中预防性使用水解蛋白配方奶。

Abstract:

Objective To systematically evaluate the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical development in preterm infants.Methods A computerized search was performed in the databases including China National Knowledge Infrastructure,Wanfang Data,Weipu,PubMed,Embase,and the Cochrane Library to identify randomized controlled trials of the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical growth in preterm infants.RevMan 5.3 software was used to perform a Meta analysis for the included studies.Results A total of 7 randomized controlled studies were included.The results of Meta analysis showed that compared with the whole protein formula,the prophylactic use of hydrolyzed protein formula could reduce the risk of neonatal necrotizing enterocolitis(RR=0.40,P=0.04)and feeding intolerance(RR=0.40,P=0.005),and had no significant effect on the growth of weight,length and head circumference(P>0.05).Conclusions Compared with the whole protein formula,the prophylactic use of hydrolyzed protein formula in preterm infants may reduce the occurrence of necrotizing enterocolitis and feeding intolerance,and can meet the nutrient requirement of physical development.However,the evidence is limited,and the results of this study cannot support the routine prophylactic use of hydrolyzed protein formula in preterm infants.