初乳口腔免疫疗法预防早产儿晚发型败血症的Meta分析

Oral immunotherapy with colostrum for the prevention of late⁃onset sepsis in premature infants:A meta⁃analysis

目的:系统评价初乳口腔免疫疗法对预防早产儿发生晚发型败血症(LOS)的影响。方法:检索PubMed、EMbase、Cochrane Library、CINAHL、Web of Science、中国知网、中国生物文献数据库、万方数据库及维普数据库中应用初乳对早产儿进行口腔免疫干预的随机对照试验,检索时间从建库至2020年9月,由两名研究人员独立筛选文献,提取资料并对文献进行质量评价(采用Cochrane Hankbook5.1. 0)采用RevMan 5.3软件进行Meta分析。结果:共纳入11项研究(研究对象861例),结果显示:应用初乳对早产儿进行口腔免疫干预和安慰剂组对比,对降低LOS的发生率有统计学意义(RR=0.69,95%CI:0.54~0.88,P=0.003),对降低坏死性小肠结肠炎无统计学意义(RR=0.65,95%CI:0.37~1.14,P=0.13)。结论:应用初乳对早产儿进行口腔免疫干预可以降低早产儿LOS的发生率,值得临床推广应用。

Objective:To systematically evaluate the effect of oral immunotherapy with colostrum on the prevention of premature′s late⁃onset sepsis(LOS).Methods::PubMed,EMbase,Cochrane Library,CINAHL,Web of science,CNKI,Chinese Biological Literature Database,Wanfang Database,and VIP database were searched for randomized controlled trials of oral immune intervention in premature infants with colostrum intake.The retrieval time was from the establishment of the database to Sep⁃tember 2020.The data were extracted and the literatures were evaluated for quality(Cochrane Hank⁃book 5.1.0).Meta analysis was performed using RevMan 5.3 software.Results::A total of 11 stud⁃ies(861 subjects)were included,and the results showed that the oral immune intervention of colos⁃trum on premature infants was statistically significant in reducing the incidence of LOS(RR=0.69,95%CI:0.54⁃0.88,P=0.003),and no statistical significance was found in reducing necrotizing en⁃terocolitis(RR=0.65,95%CI:0.37⁃1.14,P=0.13)as compared with the placebo group.Conclu⁃sion::Oral immune intervention with colostrum in premature infants can reduce the incidence of LOS in premature infants,which is worthy of clinical promotion and application.