乳铁蛋白预防早产儿晚发型败血症有效性和安全性的系统评价

doi:10.12092/j.issn.1009-2501.2018.06.009

中国临床药理学与治疗学 ›› 2018, Vol. 23 ›› Issue (6): 653-660.doi: 10.12092/j.issn.1009-2501.2018.06.009

乳铁蛋白预防早产儿晚发型败血症有效性和安全性的系统评价

韦柳萍，吴青，尹楠戈，杨彬，毛金校

重庆医科大学附属儿童医院药学部/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室，重庆 400014

收稿日期:2017-08-10 修回日期:2017-10-24 出版日期:2018-06-26 发布日期:2018-06-19
作者简介:韦柳萍，女，博士，主管药师，研究方向：医院药学及心血管药理学。 Tel：023-63625666 E-mail:weiliuping40705@163.com

Effect and safety of lactoferrin for prevention of late-onset sepsis in premature neonates: a systematic review

WEI Liuping, WU Qing, YIN Nange, YANG Bin, MAO Jinxiao

Department of Pharmacy, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China

Received:2017-08-10 Revised:2017-10-24 Online:2018-06-26 Published:2018-06-19

摘要/Abstract

摘要：

目的：系统评价口服乳铁蛋白预防早产儿晚发型败血症的有效性和安全性。方法：计算机检索Cochrane图书馆、Pubmed、EMBase、CNKI、中文科技期刊数据库以及世界卫生组织临床试验注册平台、美国临床试验注册平台和欧盟临床试验注册平台，收集乳铁蛋白对比安慰剂预防早产儿晚发型败血症的随机对照试验（RCT），对符合纳入标准的临床研究进行质量评价和资料提取后，采用 Rev Man 5.2进行Meta分析。结果：共纳入8项RCT（发表在10篇文章中），合计1 755例患者。Meta分析结果显示，无论单独口服乳铁蛋白还是口服乳铁蛋白联合益生菌均减少早产儿晚发型败血症、真菌性败血症以及Ⅱ期及以上坏死性小肠结肠炎（NEC）的发生，降低早产儿晚发型败血症归因死亡率，且均未发生不良反应或不耐受。结论：乳铁蛋白能有效预防早产儿晚发型败血症的发生。受纳入研究方法学质量及样本量限制，仍需要大样本、高质量RCT加以论证。此外，有关乳铁蛋白预防早产儿晚发型败血症的给药剂量、疗程以及乳铁蛋白的类型选择（人或牛）等还有待于进一步研究。

关键词: 乳铁蛋白, 晚发型败血症, 早产儿, 系统评价

Abstract:

AIM: To systematically review the effect and safety of lactoferrin for prevention of late-onset sepsis in premature neonates. METHODS: Cochrane Library databases, Pubmed, EMBase, CNKI, VIP Database, and WHO International Clinical Trial Registry, US Clinical Trial Registration and EU Clinical Trial Register were searched for randomized controlled trials (RCT), in which lactoferrin versus placebo in the prevention of late-onset sepsis in premature infants. After quality evaluation and data extraction，Meta-analysis was performed with Rev Man 5.2 software. RESULTS: A total of 8 RCT (published in ten reports) were included，involving 1 755 patients. Results of Meta analysis indicated that lactoferrin with or without a probiotic decreased late-onset sepsis, fungal sepsis and necrotizing enterocolitis (Bell's stage II or III) in preterm infants with no adverse effects or intolerances, and reduced late-onset sepsis-cause mortality. CONCLUSION: Lactoferrin can effectively prevent the development of late-onset sepsis in premature infants. However, due to the limit of methodological quality and sample size, it remains to be further verified with more large-scale and high-quality RCT. Furthermore, clarification regarding dosing, duration and type of lactoferrin (human or bovine) of prevention of late-onset sepsis for preterm infants is still needed.

Key words: lactoferrin, late-onset sepsis, preterm infants, systematic review

中图分类号:

R722

韦柳萍，吴青，尹楠戈，杨彬，毛金校. 乳铁蛋白预防早产儿晚发型败血症有效性和安全性的系统评价[J]. 中国临床药理学与治疗学, 2018, 23(6): 653-660.

WEI Liuping, WU Qing, YIN Nange, YANG Bin, MAO Jinxiao. Effect and safety of lactoferrin for prevention of late-onset sepsis in premature neonates: a systematic review[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(6): 653-660.

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乳铁蛋白预防早产儿晚发型败血症有效性和安全性的系统评价

Effect and safety of lactoferrin for prevention of late-onset sepsis in premature neonates: a systematic review

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