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中华妇幼临床医学杂志(电子版) ›› 2026, Vol. 22 ›› Issue (02) : 93 -102. doi: 10.3877/cma.j.issn.1673-5250.2026.02.001

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免疫因素在新生儿坏死性小肠结肠炎患儿中的作用机制的研究现状
李霞1,2, 李世平1, 屈艺1,†()   
  1. 1四川大学华西第二医院新生儿科、出生缺陷与相关妇儿疾病教育部重点实验室，成都　610041
    2泸州市妇幼保健院（泸州市第二人民医院、泸州市妇女儿童医院）新生儿科，泸州　646000
  • 收稿日期:2025-10-01 修回日期:2026-01-21 出版日期:2026-04-01
  • 通信作者: 屈艺

Current research status on mechanism of immune factors in occurrence and development of neonatal necrotizing enterocolitis

Xia Li1,2, Shiping Li1, Yi Qu1,†()   

  1. 1Department of Neonatology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    2Department of Neonatology, Luzhou Maternal and Child Health Hospital (Luzhou Second People′s Hospital), Luzhou 646000, Sichuan Province, China
  • Received:2025-10-01 Revised:2026-01-21 Published:2026-04-01
  • Corresponding author: Yi Qu
  • Supported by:
    National Natural Science Foundation of China(82371717); Project of Science and Technology Department of Sichuan Province(2024NSFSC0047)
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李霞, 李世平, 屈艺. 免疫因素在新生儿坏死性小肠结肠炎患儿中的作用机制的研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2026, 22(02): 93-102.

Xia Li, Shiping Li, Yi Qu. Current research status on mechanism of immune factors in occurrence and development of neonatal necrotizing enterocolitis[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(02): 93-102.

新生儿坏死性小肠结肠炎(NEC)是一种严重的急性炎症性肠道疾病，发病机制复杂，涉及多种围产期因素。其中，新生儿免疫系统与肠道微生态(IM)之间的相互作用，对NEC发生有显著影响。笔者拟就新生儿免疫细胞亚群、免疫分子、免疫调节因子及肠道微生物群(GM)在NEC发生中的作用机制研究现状进行阐述，重点分析免疫与GM失调导致NEC患儿肠道屏障损伤和炎症反应机制，强调免疫调节和GM干预策略在NEC的预防与治疗潜力，旨在为推动NEC患儿的免疫-微生物治疗发展提供参考。

关键词: 小肠结肠炎，坏死性, 免疫，母体获得性, 胃肠道微生物组, 免疫调节, 免疫疗法, 婴儿，新生，疾病, 肠道屏障

Neonatal necrotizing enterocolitis (NEC) is a severe acute inflammatory bowel disease with a complex pathogenesis involving various perinatal factors. Among them, the interaction between the neonatal immune system and intestinal microecology (IM) significantly affects the pathological development of neonatal NEC. This article summarizes the roles of neonatal immune cell subpopulations, immune molecules, immune regulatory factors, and gut microbiota (GM) in neonatal NEC, focusing on the mechanisms by which immune and GM dysregulation leads to intestinal barrier damage and inflammatory responses, and emphasizes the potential of immune regulation and GM intervention strategies in the prevention and treatment of neonatal NEC. The aim is to systematically summarize the research findings in this field to provide references for promoting the development of immune-microbiota therapy for neonatal NEC.

Key words: Enterocolitis, necrotizing, Immunity, maternally-acquired, Gastrointestinal microbiome, Immunomodulation, Immunotherapy, Infant, newborn, diseases, Intestinal barrier
表1 益生菌在NEC治疗中的作用机制
文献(第1作者，发表年) 益生菌的作用 作用机制 研究类型 证据等级(OCEBM2011)
Aveline[72]，2026 竞争性作用 排斥病原菌，抑制病原体的附着和定植，降低感染风险 倾向性匹配研究 3级
Abdullahi[30]，2025 增强肠道屏障功能 促进黏膜免疫的建立，增加抗菌肽和免疫球蛋白的合成，隔绝肠道病菌，提高宿主抵抗力，减少感染风险 荟萃分析 1级
Kalantar[31]，2025 调节免疫细胞功能 促进DC成熟，增强T细胞的应答反应，影响细胞因子分泌，保持免疫系统平衡 荟萃分析 1级
Dai[70]，2025 改善肠道微生物群 乳酸杆菌与双歧杆菌均可通过改善新生儿肠道微生物群、增强肠道屏障功能、调节免疫反应降低NEC发生率，二者联合使用时效果更为显著 荟萃分析 1级
Pan[32]，2024 促进短链脂肪酸生成 某些乳酸杆菌通过调节小肠微生物群，促进短链脂肪酸的生成，从而增强免疫耐受 动物实验 5级
图1 免疫-微生物轴在新生儿NEC中的作用机制及靶向干预策略示意图注：NEC为新生儿坏死性小肠结肠炎。GM为肠道微生物群。Treg为调节性T细胞，Th为辅助性T细胞。STAT为信号转导和激活因子，GATA3为一种转录因子，INF-γ为γ干扰素，IL为白细胞介素，TNF-α为肿瘤坏死因子-α，TGF-β为转化生长因子-β
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