目的 评价初乳口腔免疫疗法（colostrum oral immune therapy, COIT）对极低出生体重儿临床结局的影响。 方法 计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Web of Science、the Cochrane Library和CINAHL从建库至2024年2月发表的关于COIT应用于极低出生体重儿的随机对照试验。采用RevMan 5.3软件进行Meta分析。 结果 最终纳入14项随机对照试验，共计1 386例极低出生体重儿，其中COIT组690例，对照组696例。Meta分析结果显示：COIT降低了临床诊断晚发型败血症（late-onset sepsis, LOS）发生率（RR=0.75，95%CI：0.64~0.88，P<0.001）、血培养阳性LOS发生率（RR=0.72，95%CI：0.57~0.92，P=0.008）、病死率（RR=0.70，95%CI：0.52~0.95，P=0.020）、坏死性小肠结肠炎发生率（RR=0.65，95%CI：0.46~0.92，P=0.020）、喂养不耐受发生率（RR=0.49，95%CI：0.29~0.80，P=0.004）和缩短了达到全肠内营养的时间（MD=-2.13，95%CI：-4.03~-0.23，P=0.030）。 结论 COIT可降低极低出生体重儿LOS、坏死性小肠结肠炎和喂养不耐受的发生率及病死率，并可缩短达到全肠内营养的时间。
Abstract
Objective To evaluate the effect of colostrum oral immune therapy (COIT) on clinical outcomes in very low birth weight (VLBW) infants. Methods A computer-based search was conducted in databases including China National Knowledge Infrastructure, Wanfang Data, Weipu Database, Chinese Biomedical Literature Service System, PubMed, Embase, Web of Science, the Cochrane Library, and CINAHL for randomized controlled trials regarding the application of COIT in VLBW infants published from the establishment of the database to February 2024. Meta analysis was performed using RevMan 5.3 software. Results A total of 14 randomized controlled trials were included, involving 1 386 VLBW infants, with 690 in the COIT group and 696 in the control group. The results showed that COIT significantly reduced the incidence of clinical late-onset sepsis (LOS) (RR=0.75, 95%CI: 0.64-0.88, P<0.001), the incidence of blood culture-proven LOS (RR=0.72, 95%CI: 0.57-0.92, P=0.008), mortality rate (RR=0.70, 95%CI: 0.52-0.95, P=0.020), the incidence of necrotizing enterocolitis (RR=0.65, 95%CI: 0.46-0.92, P=0.020), and the incidence of feeding intolerance (RR=0.49, 95%CI: 0.29-0.80, P=0.004). It also shortened the time to achieve full enteral nutrition (MD=-2.13, 95%CI: -4.03 to -0.23, P=0.030). Conclusions COIT can reduce the incidence rates of LOS, necrotizing enterocolitis, and feeding intolerance, as well as the mortality rate, while also shortening the time to achieve full enteral nutrition in VLBW infants.
关键词
口腔免疫治疗 /
初乳 /
Meta 分析 /
极低出生体重儿
Key words
Oral immune therapy /
Colostrum /
Meta analysis /
Very low birth weight infant
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