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Limosilactobacillus reuteri DSM 17938作为早产婴儿的益生菌:更新的系统性审查与元分析和试验顺序分析
Ju Li Ang1, Gayatri Athalye-Jape1,2, Shripada Rao2,3
1Neonatal Directorate, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia.
JPEN. Journal of parenteral and enteral nutrition
|September 24, 2023
概括
乳杆菌reuteri (LR) DSM 17938可能会减少死性肠球炎 (NEC) 和晚发性败血症 (LOS),并缩短时间到早产婴儿的完整养 (TFF). 然而,证据的确定性非常低,需要进一步研究.
科学领域:
- 新生儿医学 新生儿医学
- 微生物学 微生物学
- 胃肠病学 胃肠病学
背景情况:
- 之前的系统性审查表明,Lactobacillus reuteri (LR) DSM 17938在减少早产婴儿死性肠球炎 (NEC),晚发性败血症 (LOS) 和完全养时间 (TFF) 的有效性.
- 在过去的六年里,该领域取得了显著的进步,需要进行更新的系统审查.
研究的目的:
- 进行最新的系统审查和对乳酸菌reuteri (LR) DSM 17938对早产婴儿的影响进行元分析.
- 评估LR DSM 17938对包括NEC,LOS,TFF和死亡率在内的关键新生儿结局的影响.
主要方法:
- 对随机对照试验 (RCT) 和非RCT进行了系统审查,搜索了多个数据库和灰色文献,直到2023年6月.
- 分析使用了随机效应模型,使用GRADE指南和试验顺序分析 (TSA) 评估RCT中NEC结果的证据确定性.
主要成果:
- 对12个RCT (n=2284) 的元分析表明,LR显著降低了TFF,NEC阶段≥II和LOS.
- 在RCT中,LR并没有显著降低所有原因的死亡率. 对非RCT的元分析显示,NEC减少,但LOS没有减少.
- 试验的顺序分析表明,对NEC结果需要更大的样本大小,证据的整体确定性被评为"非常低".
结论:
- 这些发现表明,乳杆菌reuteri (LR) DSM 17938可能有助于减少NEC和LOS,并缩短早产婴儿的TFF.
- 尽管有潜在的益处,但证据的确定性非常低,这强调需要额外的高质量随机对照试验来证实这些结果.
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