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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
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