Objective To investigate the efficacy of probiotics in prevention of necrotizing enterocolitis (NEC) in preterm infants with very low birth weight (VLBW). Methods A retrospective cohort study was car-ried out from 2012 to 2013 on 648 preterm neonates with VLBW (birth weight < 1 500 g) in our hospital. The neonates received a daily feeding supplementation with aprobiotic mixture were defined asthe exposed group , and the neonatesnot received feed supplements were defined as the control group. The relationship between the probi-otics and NEC prevention was evaluated by comparing the incidence of NEC in the two groups. Continuous vari-ables werecompared by using the Student′st test; chi-square analysis was used to evaluethe significant differences in categorical variables between two groups. Significance was defined as P < 0.05, thedatawas managedandana-lyzedbyusing the SPSS software. Results Six hundred and fifty-eight infants were eligible for inclusion in this analysis, 310 in the exposed group and 348 in the control group.Nosignificant differences inneonatal general in-formation, feeding and infection data between the groups were observed. Theincidence of NEC was 14.2% in the exposed group treated with probiotics and 21.3% in the control group with no probiotics treatment , with signifi-cant difference (P = 0.020). Theincidence of NEC reducing from 14.2% to 21.3% yielded a relative risk re-duction of 23% (RR: 0.67, 95%CI: 0.48 ~ 0.94). A higher proportion of neonates developed into severe NEC in the control group (≥stage 2) (27 of 348, 7.76%) compared with the probiotics group (12 of 310, 3.87%). The difference of theproportion neonates requiring surgery in the both two groups was not significant. Conclusion Prophylact use of probiotics was a protective factor and could reduce the incidenceof NEC in our premature neonatalpopulation with VLBW.%目的:探讨微生态制剂应用对极低出生体重(VLBW)新生儿坏死性小肠结肠炎(NEC)的预防作用,为新生儿NEC预防措施的制定提供循证依据.方法:采取回顾性队列研究,以住院期间口服微生物制剂的VLBW新生儿设为观察组, 未服用微生物制剂的新生儿设为对照组, 比较两组研究对象NEC 的发病情况,从而探究微生物制剂对VLBW 新生儿NEC 的预防作用. 结果:观察组的VLBW 新生儿有310 例,对照组348例,两组患儿的一般资料、喂养情况及感染情况比较差异无显著性. 观察组NEC发生率为14.2%,对照组为21.3%,卡方检验差异有统计学意义(P = 0.020). 相对危险度(RR)及95%置信区间为0.67(0.48 ~0.94). 观察组中重症NEC(Bell分期≥2)的发病率为3.87%,而对照组的发病率为7.76%,差异有统计学意义(P = 0.035). 在院期间,观察组和对照组 NEC 患者中各有 7 例(9.5%)、2 例(4.5%)例接受外科手术治疗,所占比例差异无显著性.结论:预防使用微生物制剂可降低VLBW新生儿NEC的发生率,谨慎使用微生物制剂对VLBW早产儿发生NEC有一定的预防作用.
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