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目的确定牛乳铁蛋白(BLF)或BLF+鼠李糖益生菌(LGG)能否降低早产儿晚发性败血症发病率。方法将广州市增城区妇幼保健院2013年1月1日-2015年12月31日新生儿重症监护病房日龄小于3 d的257名早产儿纳入本研究,随机分为BLF组(82例),BLF+LGG组(85例)和对照组(90例)。所有婴儿均进行随访,直至死亡或出院。比较3组晚发性败血症发病率。结果所有观察对象中共24例确诊为晚发性败血症。与对照组相比,BLF组和BLF+LGG组晚发性败血症发病率显著降低,差异有统计学意义(P<0.05)。BLF组、BLF+LGG组、对照组侵袭性真菌感染发病率分别为0.00%、1.17%(1例)、5.55%(5例)。BLF组与对照组侵袭性真菌感染发病率比较差异有统计学意义(χ~2=3.930,P=0.043);BLF+LGG组与对照组侵袭性真菌感染发病率比较差异有统计学意义(χ2=3.871,P=0.049)。BLF组、BLF+LGG组、对照组早产儿死亡率分别为4.87%(4例)、4.70%(4例)、6.66%(6例)。BLF组与对照组早产儿死亡率比较差异无统计学意义(χ~2=0.030,P=0.861);BLF+LGG组与对照组早产儿死亡率比较差异无统计学意义(χ~2=0.054,P=0.816)。BLF组、BLF+LGG组、对照组早产儿败血症归因死亡率分别为0.00%、1.17%(1例)、5.55%(5例)。BLF组与对照组早产儿败血症归因死亡率比较差异有统计学意义(χ~2=3.930,P=0.043);BLF+LGG组与对照组早产儿败血症归因死亡率比较差异有统计学意义(χ~2=3.871,P=0.049)。结论BLF单独使用或与LGG组合使用可减少早产儿晚发性败血症发病率。
Objectives To determine whether bovine lactoferrin (BLF) or BLF + rhamnose probiotic (LGG) can reduce the incidence of late-onset sepsis in preterm infants. Methods A total of 257 preterm infants less than 3 days old in the neonatal intensive care unit from January 1, 2013 to December 31, 2015 were enrolled in this study and randomly divided into two groups: BLF group (n = 82) , BLF + LGG group (85 cases) and control group (90 cases). All infants were followed up until they died or were discharged. The incidence of late sepsis in the three groups was compared. Results A total of 24 cases were diagnosed as late-onset sepsis in all subjects. Compared with the control group, the incidence of late sepsis in BLF group and BLF + LGG group was significantly lower (P <0.05). The incidences of invasive fungal infections in BLF group, BLF + LGG group and control group were 0.00%, 1.17% (1 case) and 5.55% (5 cases) respectively. The incidence of invasive fungal infection was significantly different between BLF group and control group (χ ~ 2 = 3.930, P = 0.043). There was significant difference in the incidence of invasive fungal infection between BLF group and control group (χ2 = 3.871, P = 0.049). The mortality rates of BLF group, BLF + LGG group and control group were 4.87% (4 cases), 4.70% (4 cases) and 6.66% (6 cases) respectively. There was no significant difference in mortality rate between BLF group and control group (χ ~ 2 = 0.030, P = 0.861). There was no significant difference in mortality rate between BLF + LGG group and control group (χ ~ 2 = 0.054 , P = 0.816). The attribution rates of sepsis in BLF group, BLF + LGG group and control group were 0.00%, 1.17% (1 case) and 5.55% (5 cases) respectively. There was significant difference in the attributable mortality rate of sepsis in preterm infants between BLF group and control group (χ ~ 2 = 3.930, P = 0.043). There was significant difference in the attributable mortality rate of sepsis among BLF + LGG group and control group (χ ~ 2 = 3.871, P = 0.049). Conclusions BLF alone or in combination with LGG can reduce the incidence of late sepsis in preterm infants.