预防性使用水解蛋白配方奶对早产儿胃肠道疾病及体格生长影响的Meta分析

doi:10.7499/j.issn.1008-8830.2109124

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摘要目的系统评价预防性使用水解蛋白配方奶对早产儿胃肠道疾病及体格发育的影响。方法计算机检索中国知网、万方、维普、PubMed、Embase、Cochrane Library等数据库，纳入关于早产儿预防性使用水解蛋白配方奶对胃肠道疾病及体格生长影响的随机对照研究。使用RevMan 5.3软件对符合纳入标准的文献进行Meta分析。结果纳入7篇随机对照研究。Meta分析结果显示，与整蛋白配方奶相比，预防性使用水解蛋白配方奶能降低早产儿发生坏死性小肠结肠炎（RR=0.40，P=0.04）和喂养不耐受（RR=0.40，P=0.005）的风险，而对早产儿体重、身长和头围发育无明显影响（P>0.05）。结论与整蛋白配方奶相比，早产儿预防性使用水解蛋白配方奶可能可减少NEC和喂养不耐受的发生，并能满足体格发育的营养需求。但目前证据有限，该研究结果尚不能支持常规在早产儿群体中预防性使用水解蛋白配方奶。

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	向祾祾
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关键词 ：水解蛋白配方奶, 坏死性小肠结肠炎, 喂养不耐受, 体格生长, Meta分析, 早产儿

Abstract：Objective To systematically evaluate the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical development in preterm infants. Methods A computerized search was performed in the databases including China National Knowledge Infrastructure, Wanfang Data, Weipu, PubMed, Embase, and the Cochrane Library to identify randomized controlled trials of the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical growth in preterm infants. RevMan 5.3 software was used to perform a Meta analysis for the included studies. Results A total of 7 randomized controlled studies were included. The results of Meta analysis showed that compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula could reduce the risk of neonatal necrotizing enterocolitis (RR=0.40, P=0.04) and feeding intolerance (RR=0.40, P=0.005), and had no significant effect on the growth of weight, length and head circumference (P>0.05). Conclusions Compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula in preterm infants may reduce the occurrence of necrotizing enterocolitis and feeding intolerance, and can meet the nutrient requirement of physical development. However, the evidence is limited, and the results of this study cannot support the routine prophylactic use of hydrolyzed protein formula in preterm infants.

Key words： Hydrolyzed protein formula Necrotizing enterocolitis Feeding intolerance Physical growth Meta analysis Preterm infant

收稿日期: 2021-09-22

通讯作者: 华子瑜，女，教授。Email：h_ziyu@163.com。 E-mail: h_ziyu@163.com

作者简介: 向祾祾，女，硕；

引用本文:

向祾祾,胡源源,夏旭花等. 预防性使用水解蛋白配方奶对早产儿胃肠道疾病及体格生长影响的Meta分析[J]. 中国当代儿科杂志, 2022, 24(2): 169-175.

XIANG Ling-Ling,HU Yuan-Yuan,XIA Xu-Hua et al. Effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical growth in preterm infants: a Meta analysis[J]. CJCP, 2022, 24(2): 169-175.

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	Harding JE, Cormack BE, Alexander T, et al. Advances in nutrition of the newborn infant[J]. Lancet, 2017, 389(10079): 1660-1668. PMID: 28443560. DOI: 10.1016/S0140-6736(17)30552-4.
	中华医学会肠外肠内营养学分会儿科协作组, 中华医学会儿科学分会新生儿学组, 中华医学会小儿外科学分会新生儿学组. 中国新生儿营养支持临床应用指南[J]. 中华儿科杂志, 2006, 44(9): 711-714. PMID: 17217674. DOI: 10.3760/j.issn:0578-1310.2006.09.023.
	中国医师协会新生儿科医师分会营养专业委员会, 中国医师协会儿童健康专业委员会母乳库学组, 《中华儿科杂志》编辑委员会. 新生儿重症监护病房推行早产儿母乳喂养的建议[J]. 中华儿科杂志, 2016, 54(1): 13-16. PMID: 27470475. DOI: 10.3760/cma.j.issn.0578-1310.2016.01.004.
	Staelens S, Van den Driessche M, Barclay D, et al. Gastric emptying in healthy newborns fed an intact protein formula, a partially and an extensively hydrolysed formula[J]. Clin Nutr, 2008, 27(2): 264-268. PMID: 18280619. DOI: 10.1016/j.clnu.2007.12.009.
	Corvaglia L, Mariani E, Aceti A, et al. Extensively hydrolyzed protein formula reduces acid gastro-esophageal reflux in symptomatic preterm infants[J]. Early Hum Dev, 2013, 89(7): 453-455. PMID: 23642476. DOI: 10.1016/j.earlhumdev.2013.04.003.
	Sackesen C, Altintas DU, Bingol A, et al. Current trends in tolerance induction in cow's milk allergy: from passive to proactive strategies[J]. Front Pediatr, 2019, 7: 372. PMID: 31620408. PMCID: PMC6760011. DOI: 10.3389/fped.2019.00372.
	von Berg A, Filipiak-Pittroff B, Schulz H, et al. Allergic manifestation 15 years after early intervention with hydrolyzed formulas: the GINI study[J]. Allergy, 2016, 71(2): 210-219. PMID: 26465137. PMCID: PMC4738469. DOI: 10.1111/all.12790.
	Salvatore S, Vandenplas Y. Hydrolyzed proteins in allergy[J]. Nestle Nutr Inst Workshop Ser, 2016, 86: 11-27. PMID: 27336625. DOI: 10.1159/000442699.
	Osborn DA, Sinn JK, Jones LJ. Infant formulas containing hydrolysed protein for prevention of allergic disease[J]. Cochrane Database Syst Rev, 2018, 10(10): CD003664. PMID: 30338526. PMCID: PMC6517017. DOI: 10.1002/14651858.CD003664.pub6.
	Ng DHC, Klassen JR, Embleton ND, et al. Protein hydrolysate versus standard formula for preterm infants[J]. Cochrane Database Syst Rev, 2019, 7(7): CD012412. PMID: 31339557. PMCID: PMC6653062. DOI: 10.1002/14651858.CD012412.pub3.
	Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria[J]. Pediatr Clin North Am, 1986, 33(1): 179-201. PMID: 3081865. PMCID: PMC7131118. DOI: 10.1016/s0031-3955(16)34975-6.
	Kuzma-O'Reilly B, Duenas ML, Greecher C, et al. Evaluation, development, and implementation of potentially better practices in neonatal intensive care nutrition[J]. Pediatrics, 2003, 111(4 Pt 2): e461-e470. PMID: 12671166.
	Oremus M, Wolfson C, Perrault A, et al. Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer's disease drug trials[J]. Dement Geriatr Cogn Disord, 2001, 12(3): 232-236. PMID: 11244218. DOI: 10.1159/000051263.
	顾春燕, 蒋慧芬, 王金秀. 深度水解蛋白配方奶喂养对极低/超低出生体重儿生长发育的影响[J]. 中国当代儿科杂志, 2017, 19(8): 852-855. PMID: 28774357. PMCID: PMC7390041. DOI: 10.7499/j.issn.1008-8830.2017.08.002.
	15 赵晓君. 三种不同奶粉喂养对早产儿喂养耐受性的影响[D]. 郑州: 郑州大学, 2017.
	16 阳倩, 张渝. 深度水解蛋白配方奶粉在早产儿中的运用研究[J]. 中国妇幼保健, 2016, 31(15): 3071-3073. DOI: 10.7620/zgfybj.j.issn.1001-4411.2016.15.32.
	Borschel MW, Choe YS, Kajzer JA. Growth of healthy term infants fed partially hydrolyzed whey-based infant formula: a randomized, blinded, controlled trial[J]. Clin Pediatr (Phila), 2014, 53(14): 1375-1382. PMID: 25009115. DOI: 10.1177/0009922814541804.
	18 蒋丽军, 刘志峰. 完全水解蛋白配方奶对早产儿生长的影响[J]. 儿科药学杂志, 2014, 20(11): 23-25. DOI: 10.13407/j.cnki.jpp.1672-108X.2014.11.008.
	19 胡玉莲, 夏世文. 深度水解蛋白配方奶对极低出生体质量儿喂养的影响[J]. 实用儿科临床杂志, 2011, 26(14): 1091-1092. DOI: 10.3969/j.issn.1003-515X.2011.14.009.
	Hauser B, Blecker U, Keymolen K, et al. Plasma amino acid concentrations in term-born infants fed a whey predominant or a whey hydrolysate formula[J]. JPEN J Parenter Enteral Nutr, 1997, 21(1): 27-30. PMID: 9002081. DOI: 10.1177/014860719702100127.
	21 尹莉萍, 唐月华, 陈艳, 等. 深度水解蛋白配方奶在早产儿中的临床研究[J]. 东南大学学报(医学版), 2015, 34(4): 546-551. DOI: 10.3969/j.issn.1671-6264.2015.04.011.
	Picaud JC, Rigo J, Normand S, et al. Nutritional efficacy of preterm formula with a partially hydrolyzed protein source: a randomized pilot study[J]. J Pediatr Gastroenterol Nutr, 2001, 32(5): 555-561. PMID: 11429516. DOI: 10.1097/00005176-200105000-00012.
	Mihatsch WA, Franz AR, H?gel J, et al. Hydrolyzed protein accelerates feeding advancement in very low birth weight infants[J]. Pediatrics, 2002, 110(6): 1199-1203. PMID: 12456919. DOI: 10.1542/peds.110.6.1199.
	Maggio L, Zuppa AA, Sawatzki G, et al. Higher urinary excretion of essential amino acids in preterm infants fed protein hydrolysates[J]. Acta Paediatr, 2005, 94(1): 75-84. PMID: 15858965. DOI: 10.1111/j.1651-2227.2005.tb01792.x.
	Florendo KN, Bellflower B, van Zwol A, et al. Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula[J]. J Perinatol, 2009, 29(2): 106-111. PMID: 18716627. DOI: 10.1038/jp.2008.124.
	Baldassarre ME, Di Mauro A, Fanelli M, et al. Shorter time to full preterm feeding using intact protein formula: a randomized controlled trial[J]. Int J Environ Res Public Health, 2019, 16(16): 2911. PMID: 31416171. PMCID: PMC6720977. DOI: 10.3390/ijerph16162911.
	27 张亚芥, 代传林, 李丹, 等. 深度水解蛋白配方奶在极/超低出生体重儿肠内营养中的临床观察[J]. 中华新生儿科杂志(中英文), 2017, 32(6): 431-434. DOI: 10.3760/cma.j.issn.2096-2932.2017.06.007.
	李雪梅, 蒋静, 吴艳, 等. 不同开奶配方应用于极低出生体重儿的临床研究[J]. 中国当代儿科杂志, 2019, 21(8): 777-782. PMID: 31416502. PMCID: PMC7389906. DOI: 10.7499/j.issn.1008-8830.2019.08.008.
	Mennella JA, Ventura AK, Beauchamp GK. Differential growth patterns among healthy infants fed protein hydrolysate or cow-milk formulas[J]. Pediatrics, 2011, 127(1): 110-118. PMID: 21187303. PMCID: PMC3010087. DOI: 10.1542/peds.2010-1675.
	30 World Health Organization. A randomized, controlled, double-blind parallel group trial to study the effects of an infant formula containing partially hydrolysed proteins on growth and tolerance in healthy term infants [EB/OL]. (2021-07-31)[2021-09-11]. https://trialsearch.who.int/?TrialID=NL9536.
	31 U.S. National Library of Medicine. Infants fed extensively hydrolyzed casein-based infant formulas[EB/OL]. (2019-08-05)[2021-08-14]. https://clinicaltrials.gov/ct2/show/NCT04006236.
	32 World Health Organization. Growth and tolerance of healthy term infants fed infant formula with 100% whey protein hydrolysate or intact milk proteins (penguin project)[EB/OL]. (2018-11-27)[2021-08-14]. https://trialsearch.who.int/?TrialID=DRKS00016462.