益生菌预防新生儿坏死性小肠结肠炎效果的Meta分析

目的:系统评价益生菌预防新生儿坏死性小肠结肠炎(NEC) 的有效性和安全性。方法:计算机检索PubMed、EMBase、the Cochrane Library、Web of Science、中国知网、维普、万方、中国生物医学文献数据库中关于益生菌预防新生儿NEC 的随机对照试验(RCT),检索时限均为建库至2023 年4 月。由2 名评价者独立筛选文献、提取资料和评估方法学质量后,采用Stata 15. 1 SE和RevMan 5. 4 软件进行Meta 分析。结果:最终纳入29 篇RCT,共6 354 例患儿。Meta 分析结果显示,预防性使用益生菌可显著降低新生儿NEC 发生率(OR=0. 30,95%CI 0. 24~0. 37,P<0. 05)。共9 项RCT 提及NEC 相关病死率,预防性使用益生菌能显著降低新生儿NEC 相关病死率(OR=0. 35,95%CI 0. 17~0. 70,P<0. 05)。结论:预防性使用益生菌可降低新生儿NEC 发生风险和相关病死率。

Meta-Analysis on Efficacy of Probiotics in the Prevention of Neonatal Necrotizing Nterocolitis

Objective: To systematically review the efficacy and safety of probiotics in the prevention of neonatal necrotizing enterocolitis(NEC). Methods: PubMed, EMBase, the Cochrane Library, Web of Science, CNKI, VIP, Wanfang and CBM were retrieved tocollect randomized controlled trials (RCT) of probiotics in the prevention of neonatal NEC. The retrieval time was from the establishmentof the databases to Apr. 2023. Meta-analysis was performed by using Stata 15. 1 SE and RevMan 5. 4 software after independentselection of trials, extraction of information and assessment of methodological quality by two evaluators. Results: A total of 29 RCT wereenrolled, including 6,354 children. Meta-analysis showed that prophylactic use of probiotics significantly reduced the incidence ofneonatal NEC (OR=0. 30, 95% CI from 0. 24 to 0. 37, P<0. 05). NEC-related fatality was mentioned in 9 RCT, and prophylactic useof probiotics significantly reduced neonatal NEC-related fatality (OR = 0. 35, 95% CI from 0. 17 to 0. 70, P <0. 05). Conclusion:Prophylactic use of probiotics can reduce the risk of NEC and related fatality in neonates.