Probiotics and the prevention of necrotizing enterocolitis
Probiotics and the prevention of necrotizing enterocolitis
复制标题
DOI：
10.1016/j.jpedsurg.2018.08.055
复制
发表时间：
2019-03-01
影响因子：
2.4
通讯作者：
Underwood, Mark A.
中科院分区：
文献类型：
--
作者：
Underwood, Mark A.
背景：宿主免疫系统的不成熟和肠道微生物群的改变似乎是坏死性小肠结肠炎(NEC)发病的关键因素。本文的目的是评估使用益生菌预防早产儿NEC的证据。方法：对动物研究、随机对照试验、观察性队列研究和涉及使用益生菌产品预防NEC的荟萃分析进行综述。本文综述了现有的临床前和临床资料。结果：在动物模型中，益生菌改变肠道微生物群，减少炎症和肠道通透性，降低实验性NEC的发生率和严重性。在早产儿的随机、安慰剂对照试验和队列研究中，益生菌降低了NEC、死亡和败血症的风险。结论：有强有力的证据表明，在接受母乳喂养的早产儿中使用联合益生菌可以预防NEC。给早产儿服用益生菌的潜在风险和益处应该与父母一起仔细审查。研究类型：治疗性。(C)2018 Elsevier Inc.保留所有权利。
Background: Immaturity of the host immune system and alterations in the intestinal microbiome appear to be key factors in the pathogenesis of necrotizing enterocolitis (NEC). The aim of this paper is to weigh the evidence for the use of probiotics to prevent NEC in premature infants.Methods: Animal studies, randomized controlled trials, observational cohort studies and meta-analyses involving administration of probiotic products for the prevention of NEC were reviewed. This review of the evidence summarizes the available preclinical and clinical data.Results: In animal models probiotic microbes alter the intestinal microbiome, decrease inflammation and intestinal permeability and decrease the incidence and severity of experimental NEC. In randomized, placebo-controlled trials and cohort studies of premature infants, probiotic microbes decrease the risk of NEC, death and sepsis.Conclusion: Evidence is strong for the prevention of NEC with the use of combination probiotics in premature infants who receive breast milk. The potential risks and benefits of probiotic administration to premature infants should be carefully reviewed with parents.Type of study: Therapeutic. (C) 2018 Elsevier Inc. All rights reserved.