Abstract:

Necrotizing enterocolitis（NEC） is considered to be the most common gastrointestinal emergency among neonates. Although the pathogenesis of NEC is incompletely understood，there are several established risk factors，including prematurity，altered intestinal blood flow/oxygen delivery，formula feeding and bacterial infection. Recently，a large number of studies showed that intestinal flora imbalance had been implicated as key risk factor in the pathogenesis of NEC. After birth，the neonatal gut must acquire a healthy complement of commensal bacteria，which leads to deficient or abnormal microbial colonization of the gut，may protect the immature gut from inflammation and injury. Providing a healthy complement of commensal bacteria can maintain the intestinal microflora balance，shift the balance of intestinal microbiota from a pathegenic to protective complement of bacteria，protect the gut from inflammation and subsequent injury，and prevent NEC. We review the relationship between intestinal microbiota and NEC in preterm infants，the mechanism of probiotics in preventing NEC，and the efficacy and safety of probiotics in preterm infants.

Key words: probiotics, premature infants, necrotizing enterocolitis, intestinal microbiota

摘要：

新生儿坏死性小肠结肠炎（NEC）是新生儿期常见的严重胃肠道急症，以往研究认为，早产、感染、配方奶喂养、缺血缺氧是引发NEC的重要因素。近年来大量研究表明，肠道菌群失衡是引发NEC的重要和基础原因，新生儿生后肠道获取健康的共生菌，可以阻断因肠道正常菌群缺失或异常的菌群定植过程，使未成熟肠道免于炎症或损伤，这是降低NEC发生风险的关键因素。提供益生菌可维护肠道菌群平衡，使致病型微生态模式转换至保护型健康的微生态模式，防御肠道的炎症损害，预防NEC发生。此篇文章阐述了早产儿NEC与肠道菌群的关系，阐明了益生菌制剂防治NEC的作用机制、临床疗效和安全性。

关键词: 益生菌, 早产儿, 坏死性小肠结肠炎, 肠道菌群