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益生菌补充剂 - 它可以预防或引起新生儿败血症吗?
Nicholas D Embleton1, Chris H P van den Akker2, Belal N Alshaikh3
1Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Newcastle University, Newcastle upon Tyne, UK.
Seminars in fetal & neonatal medicine
|October 1, 2025
概括
益生菌补充剂显著降低死性肠球炎 (NEC) 和早产婴儿的死亡率. 虽然对晚发性败血症 (LOS) 的影响很小,但整体的安全性和益处支持它们在新生儿学中的使用.
科学领域:
- 新生儿医学 新生儿医学
- 微生物组研究 微生物组研究
- 临床营养学 临床营养学
背景情况:
- 益生菌补充剂在早产婴儿中被广泛研究.
- 对于新生儿中益生菌的50多个随机对照试验存在.
- 已确定的好处包括减少死性肠球炎 (NEC) 和死亡率.
研究的目的:
- 检查益生菌使用与早产婴儿晚发性败血症 (LOS) 之间的关系.
- 审查机械路径,临床证据和安全数据.
- 评估益生菌对早产婴儿的整体益处风险概况.
主要方法:
- 随机对照试验的系统审查和元分析.
- 对减少败血症的机制性途径的分析.
- 评估安全数据,包括不良事件和益生菌诱导的败血症.
- 对NEC和死亡率降低的证据的评估.
主要成果:
- 益生菌在降低LOS方面显示出适度的影响 (RR 0.89,低确定性).
- 机制包括病原体排除,增强屏障功能和改善免疫力.
- 严重的不良事件很少发生;益生菌诱导的败血症风险<0.5%.
- 强有力的证据支持显著减少NEC和全因死亡率.
结论:
- 益生菌对早产婴儿非常有益,主要用于NEC和降低死亡率.
- 目前对LOS的影响被认为是温和的,确定性低.
- 整体的益处与风险概况强烈支持益生菌的使用,尽管对LOS和抗体的影响仍有持续的研究需求.
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