系统评价中国新生儿发生抗菌药物相关性腹泻的危险因素

陈瑞阳; 涂雪松<sup>*</sup>; 杨恩华; 李莉

引用本文:	陈瑞阳,涂雪松,杨恩华,李莉.系统评价中国新生儿发生抗菌药物相关性腹泻的危险因素[J].中国现代应用药学,2019,36(12):1546-1552.
	CHEN Ruiyang,TU Xuesong,YANG Enhuab,LI Li.Systematic Evaluation of Risk Factors for Antibiotic-associated Diarrhea in Chinese Nneonates[J].Chin J Mod Appl Pharm(中国现代应用药学),2019,36(12):1546-1552.

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系统评价中国新生儿发生抗菌药物相关性腹泻的危险因素
陈瑞阳¹, 涂雪松¹, 杨恩华², 李莉²
1.孝感市中心医院药剂科, 湖北孝感 432000;2.孝感市中心医院新生儿科, 湖北孝感 432000

摘要:

目的系统评价中国新生儿患者发生抗菌药物相关性腹泻（antibiotic-associated diarrhea，AAD）的危险因素。方法检索PubMed、Embase、CNKI、VIP、CBM、万方等相关数据库，收集中国新生儿患者发生AAD危险因素的病例对照研究，检索年限为数据库建库至2018年3月，采用纽卡斯尔-渥太华质量评估量表对纳入文献进行质量评价，并应用RevMan 5.2软件进行meta分析。结果共纳入15篇文献，涉及6 838例患儿，其中AAD组1 038例，非AAD组5 800例。Meta分析结果显示，AAD的危险因素为侵袭性操作（OR=3.70，95%CI=3.16~4.34，P<0.01）、住院时间≥ 15 d（OR=3.12，95%CI=2.57~3.79，P<0.01）、胎龄<37周（OR=2.56，95%CI=2.11~3.11，P<0.01）、日龄<7 d（OR=2.56，95%CI=2.10~3.13，P<0.01）、出生时体质量<2.5 kg（OR=1.89，95%CI=1.54~2.33，P<0.01）、抗菌药物联用（OR=1.49，95%CI=1.15~1.94，P=0.003）和母乳喂养（OR=0.69，95%CI=0.53~0.90，P=0.007）。结论低胎龄、出生时低体质量、出生日龄偏小、抗菌药物联用、侵袭性操作、住院时间过长及非母乳喂养是新生儿发生AAD的危险因素。

关键词: 抗菌药物相关性腹泻新生儿中国人群危险因素 meta分析

DOI：10.13748/j.cnki.issn1007-7693.2019.12.019

分类号:R969.3

基金项目:

Systematic Evaluation of Risk Factors for Antibiotic-associated Diarrhea in Chinese Nneonates

CHEN Ruiyang¹, TU Xuesong¹, YANG Enhuab², LI Li²

1.Department of Pharmaceutical, Central Hospital of Xiaogan City, Xiaogan 432000, China;2.Department of Newborn Pediatrics, Central Hospital of Xiaogan City, Xiaogan 432000, China

Abstract:

OBJECTIVE To evaluate the risk factors for antibiotic-associated diarrhea(AAD) in Chinese neonates. METHODS The related databases of PubMed,Embase,CNKI,VIP,CBM,and Wanfang were electronically searched for the case-control studies about risk factors for AAD in neonates from database building to March 2018. The quality of the literature evaluated by Newcastle Ottawa Scale,and then meta-analysis was conducted using RevMan 5.2 software. RESULTS Total of 15 studies involving and 6 838 patients were entered, including 1 038 in the AAD group and 5 800 in the non-AAD group. The result of meta analysis showed that invasive operation(OR=3.70, 95%CI=3.16-4.34, P<0.01), hospital stay ≥ 15 d(OR=3.12, 95%CI=2.57-3.79, P<0.01), fetal age < 37 w(OR=2.56, 95%CI=2.11-3.11, P<0.01), age days<7 d(OR=2.56, 95%CI=2.10-3.13, P<0.01), birth weight < 2.5 kg(OR=1.89, 95%CI=1.54-2.33, P<0.01), antibiotics combination(OR=1.49, 95%CI=1.15-1.94, P=0.003) and non-breastfeeding(OR=0.69, 95%CI=0.53-0.90, P=0.007) were risk factors for AAD in Chinese neonates. CONCLUSION Current evidence shows that low gestational age, low birth weight, low birth age, antibiotic combination, invasive operation, long hospital stay, non-breastfeeding are risk factors for AAD in neonates.

Key words: antibiotic-associated diarrhea(AAD) neonates Chinese risk factor meta-analysis