益生菌预防新生儿坏死性小肠结肠炎效果的Meta分析

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

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。

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 to collect randomized controlled trials(RCT)of probiotics in the prevention of neonatal NEC.The retrieval time was from the establishment of the databases to Apr.2023.Meta-analysis was performed by using Stata 15.1 SE and RevMan 5.4 software after independent selection of trials,extraction of information and assessment of methodological quality by two evaluators.Results:A total of 29 RCT were enrolled,including 6,354 children.Meta-analysis showed that prophylactic use of probiotics significantly reduced the incidence of neonatal 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 use of 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.