目的 系統(tǒng)評(píng)價(jià)新生兒發(fā)生抗生素相關(guān)性腹瀉（AAD）的危險(xiǎn)因素，為臨床提供循證醫(yī)學(xué)證據(jù)。方法 檢索PubMed、Embase、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM）、維普中文科技期刊數(shù)據(jù)庫(kù)（VIP）和萬(wàn)方數(shù)據(jù)庫(kù)等相關(guān)數(shù)據(jù)庫(kù)，收集新生兒發(fā)生AAD危險(xiǎn)因素的病例對(duì)照研究，檢索時(shí)限為2000年1月-2018年5月，應(yīng)用Rev Man 5.2軟件進(jìn)行Meta-分析。結(jié)果 共納入13篇文獻(xiàn)，涉及4 273例新生兒，其中AAD組915例，非AAD組3 358例。Meta-分析結(jié)果顯示：低胎齡（SMD=-0.89，95%CI=-1.16~-0.61，P<0.01），出生時(shí)體質(zhì)量偏小（SMD=-0.79，95%CI=-0.98~-0.59，P<0.01），日齡偏小（SMD=-1.08，95%CI=-1.20~-0.96，P<0.01），抗生素種類(lèi)（SMD=1.59，95%CI=1.24~1.94，P<0.01），侵襲性操作（OR=2.06，95%CI=1.85~2.23，P<0.01），住院天數(shù)（SMD=2.21，95%CI=1.86~2.56，P<0.01）和非純母乳喂養(yǎng)（OR=0.47，95%CI=0.38~9.57，P<0.01）是新生兒發(fā)生AAD的危險(xiǎn)因素，抗生素預(yù)防用藥（OR=1.17，95%CI=0.94~1.46，P>0.05）與新生兒發(fā)生AAD無(wú)關(guān)。結(jié)論 低胎齡、出生時(shí)體質(zhì)量偏小、日齡小、多種抗生素聯(lián)合用藥、住院時(shí)間過(guò)長(zhǎng)、侵襲性操作和非純母乳喂養(yǎng)是新生兒發(fā)生AAD的危險(xiǎn)因素。

Objective To evaluate the risk factors for antibiotic-associated diarrhea (AAD) in neonates,and to provide evidencebased medical for clinical.Method The related databases of PubMed,Embase,CNKI,CBM,VIP and Wanfang Data were electronically searched for the case-control studies about risk factors for AAD in neonates from January 2010 to May 2018.Metaanalysis was conducted by RevMan 5.2 Software.Results A total of 13 studies involving 4 273 patients were studied,including 915 in the AAD group and 3 358 in the non-AAD group.The result of Meta-analysis showed that,the lower gestational age (SMD=-0.89,95%CI=-1.16~-0.61,P<0.01),lower birth weight (SMD=-0.79,95%CI=-0.98~-0.59,P<0.01),lower days age (SMD=-1.08,95%CI=-1.20~-0.96,P<0.01),combination of antibiotic (SMD=1.59,95%CI=1.24~1.94,P<0.01),longer hospital stay (SMD=2.21,95%CI=1.86~2.56,P<0.01),Invasive procedures (OR=2.06,95%CI=1.85~2.23,P<0.01) and non-pure breastfeeding (OR=0.47,95%CI=0.38~9.57,P<0.01) were risk factors for AAD in neonates,and prevention of antibiotic (OR=1.17,95%CI=0.94~1.46,P>0.05) was no risk factor for AAD in neonates.Conclusion Lower gestational age,lower birth weight,lower age,combination of antibiotics,longer hospital stay,Invasive procedures and non-pure breastfeeding are risk factors for AAD in neonates.