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初始经验性抗生素治疗与早期发生败血症的不同风险非常早产婴儿的死角肠炎之间的关联:一个多中心队列研究
Zhenyu Li1,2, Jie Yang3, Xinyue Gu3
1Department of Neonatology, Children's Medical Center, The First Hospital of Jilin University, NO.1 Xinmin Street, Changchun, 130021, Jilin, China.
BMC pregnancy and childbirth
|February 17, 2026
概括
短期初始实证抗生素治疗 (IEAT) 可能降低非常早产婴儿死性肠球炎 (NEC) 的风险. 然而,长时间的IEAT持续时间似乎会增加NEC风险在不同的早期发作败血症 (EOS) 风险水平.
科学领域:
- 新生儿医学 新生儿医学
- 儿童传染病 儿童传染病
- 临床药理学 临床药理学
背景情况:
- 死性肠球炎 (NEC) 是非常早产婴儿的一个重大问题.
- 早发性败血症 (EOS) 的风险在早产新生儿之间有所不同.
- 最初的经验性抗生素治疗 (IEAT) 通常用于疑似EOS.
研究的目的:
- 调查IEAT持续时间与NEC发病率之间的关联.
- 为了探索这一关联在EOS风险分层的非常早产婴儿.
- 为了确定更短或更长的IEAT持续时间是否会影响NEC风险.
主要方法:
- 对VLBW婴儿 (<32周妊娠期) 的前性,观察性,多中心研究.
- 没有培养证明EOS的婴儿被按EOS风险分类.
- 竞争风险的考克斯回归和受限立方支线模型分析了IEAT持续时间 (0,<3,3-5,>5天) 和NEC发病率.
主要成果:
- 在整体队列和非低风险EOS组中,IEAT<3天与明显较低的NEC风险有关.
- 与没有IEAT相比,3-5天的IEAT也显示了较低NEC风险的趋势.
- 在低风险的EOS组中没有发现显著的关联;然而,RCS分析表明IEAT持续时间和NEC风险之间存在正线性关系.
结论:
- 短期IEAT (<3天) 可能与非常早产婴儿的NEC风险相反相关,特别是在非低风险EOS的婴儿中.
- 长时间的IEAT持续时间 (>5天) 可能与NEC的风险增加有关.
- 这些发现是探索性的,并表明在这个人群中明智使用抗生素的潜在好处.
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