Article(id=1311350372728398329, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349984730116963, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202601240, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1768406400000, receivedDateStr=2026-01-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579892570, onlineDateStr=2026-09-28, pubDate=1784908800000, pubDateStr=2026-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579892570, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579892570, creator=13701087609, updateTime=1790579892570, updator=13701087609, issue=Issue{id=1311349984730116963, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='1784908800000', pubDateStr='2026-07-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790579800064, creator='13701087609', updateTime=1790588348354, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311385838924169506, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349984730116963, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311385838924169507, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349984730116963, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2581, endPage=2587, ext={EN=ArticleExt(id=1311350372929724922, articleId=1311350372728398329, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The impact of delivery mode and feeding mode on gut microbiota in early life and infant allergies, columnId=1228016572783063333, journalTitle=Modern Preventive Medicine, columnName=Nutrition and Food Hygiene, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the impact of early life factors on the initial establishment of infant gut microbiota and their association with allergic diseases in infancy.

Methods

A nested case-control study was conducted involving 82 samples from the maternal-infant cohorts established at West China Second University Hospital and Chengdu Women’s and Children’s Central Hospital.

Results

In the vaginal delivery group, the incidence of allergic diseases in infants (30.30%) was lower than that in the cesarean section group (51.02%), with no statistically significant difference; in the breastfeeding group, the incidence (31.81%) was lower than that in the mixed feeding group (55.26%), and the difference was statistically significant (P=0.063; P=0.032). On day 0, the Simpson index in the allergic group was significantly higher than that in the healthy group (P<0.05). By day 30, the healthy group exhibited more favorable microbial richness-related indices of the gut microbiota. On day 7, the relative abundance of Bdellovibrionota in the allergic mixed-fed group was significantly higher than that in other groups (P<0.05). The relative abundance of Bifidobacterium in feces was significantly higher in the healthy group than in the allergic group on day 7 (P<0.05), and the abundance of Bifidobacterium in breast milk of the healthy group remained higher than that of the allergic group from day 0 to day 30.

Conclusion

Vaginal delivery is conducive to maintaining the diversity of gut microbiota in early infancy and establishing a gut microbiota pattern dominated by Bifidobacterium. Meanwhile, breastfeeding promotes the colonization of probiotics such as Bifidobacterium, thereby reducing the long-term risk of allergies in infants.

, authors=Lun-pu ZHANG, Chang LU, Yao ZENG, Xiao-ting LI, Hua-jiao WU, Ming-hao HUANG, Fang HE, Xi SHEN, authorsList=Lun-pu ZHANG, Chang LU, Yao ZENG, Xiao-ting LI, Hua-jiao WU, Ming-hao HUANG, Fang HE, Xi SHEN, authorCompany=null, correspAuthors=Xi SHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311350375819600407, articleId=1311350372728398329, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=分娩方式与喂养方式对生命早期肠道菌群及婴儿过敏的影响, columnId=1228016573034721597, journalTitle=现代预防医学, columnName=营养与食品卫生, runingTitle=null, highlight=null, articleAbstract=
目的

探究生命早期因素对婴儿肠道菌群起始构建的影响,以及其与婴儿期过敏性疾病的关联。

方法

在华西第二医院、成都市妇幼保健院建立的母婴队列中纳入过敏组样本35例和对照组样本47例进行病例对照研究。

结果

顺产组婴儿过敏性疾病发病率(30.30%)低于剖宫产组(51.02%),差异无统计学意义(P=0.063);母乳喂养组发病率(31.81%)低于混合喂养组(55.26%),差异有统计学意义(P=0.032)。在第0天时过敏组Simpson指数高于健康组(P<0.05),在第30天时健康组菌群丰富度相关指数更优。第7天时过敏混合喂养组蛭弧菌门(Bdellovibrionota)高于其他组(P<0.05);健康组第7天时粪便双歧杆菌属(Bifidobacterium)相对丰度高于过敏组(P<0.05),且健康组母乳中双歧杆菌属丰度在0-30天持续高于过敏组。

结论

顺产有益于婴儿早期维持肠道菌群的多样性、构建以双歧杆菌为优势地位的肠道菌群模式,同时母乳喂养也促进双歧杆菌等益生菌定植,进而降低婴儿远期过敏风险。

, authors=张伦溥, 逯畅, 曾瑶, 黎晓婷, 吴华娇, 黄明豪, 何方, 沈曦, authorsList=张伦溥, 逯畅, 曾瑶, 黎晓婷, 吴华娇, 黄明豪, 何方, 沈曦, authorCompany=null, correspAuthors=沈曦, authorNote=

张伦溥(2000—),男,硕士,研究方向:肠道菌群与健康研究

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沈曦,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=IWbXP3HTG2JdKkrH73NQ5A==, magXml=ByqWwd/zOHmmNqgGUQiveA==, pdfUrl=null, pdf=cjcnNUc48v2/K7KNbnPjTw==, pdfFileSize=1168452, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=HPnHq/fahr1PBs5AUBzL3A==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=u4Drr1oysWdybi/1pYJhtQ==, mapNumber=null, fund=null)}, authors=[Author(id=1311350376134173212, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1311350376218059294, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, authorId=1311350376134173212, language=EN, stringName=Lun-pu ZHANG, firstName=Lun-pu, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1311350376293556767, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, authorId=1311350376134173212, language=CN, stringName=张伦溥, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=四川大学华西公共卫生学院(四川大学华西第四医院),四川 成都 610041, bio={"content":"

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tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, language=CN, label=图13, caption=两组婴儿母乳菌群中Bifidobacterium的相对丰度随时间变化趋势, figureFileSmall=GjuX3YC3+JenPz/d2HDF+Q==, figureFileBig=LFK+2IaM1tA8aD4s4w+zTA==, tableContent=null), ArticleFig(id=1311350381033120359, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, language=EN, label=Table 1, caption=

The sample size of fecal and breast milk sequencing from the participating infants

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组别纳入婴儿数粪便测序数母乳测序数
0 d7 d1 m0 d1 m
A3525252576
NA4727272797
A-VD1057746
A-CS2514171770
NA-VD2311131343
NA-CS247131314
A-BF1499875
A-MF2112121801
NA-BF3016161676
NA-MF17991021
), ArticleFig(id=1311350381108617832, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, language=CN, label=表1, caption=

受试婴儿的粪便和母乳测序样本量

, figureFileSmall=null, figureFileBig=null, tableContent=
组别纳入婴儿数粪便测序数母乳测序数
0 d7 d1 m0 d1 m
A3525252576
NA4727272797
A-VD1057746
A-CS2514171770
NA-VD2311131343
NA-CS247131314
A-BF1499875
A-MF2112121801
NA-BF3016161676
NA-MF17991021
), ArticleFig(id=1311350381192503913, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, language=EN, label=Table 2, caption=

Chi-square test for the prevalence of allergic diseases in infants with two delivery modes

, figureFileSmall=null, figureFileBig=null, tableContent=
组别组别(%)总计P值
顺产组剖宫产组
健康23(69.70)24(48.98)47(57.32)
过敏10(30.30)25(51.02)35(42.68)0.063
总计334982
), ArticleFig(id=1311350381284778602, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, language=CN, label=表2, caption=

两种分娩方式婴儿过敏性疾病患病率卡方检验

, figureFileSmall=null, figureFileBig=null, tableContent=
组别组别(%)总计P值
顺产组剖宫产组
健康23(69.70)24(48.98)47(57.32)
过敏10(30.30)25(51.02)35(42.68)0.063
总计334982
), ArticleFig(id=1311350381381247595, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, language=EN, label=Table 3, caption=

Chi-square test for the prevalence of allergic diseases in infants with two feeding modes

, figureFileSmall=null, figureFileBig=null, tableContent=
组别组别(%)总计P值
母乳喂养组混合喂养组
健康30(68.18)17(44.74)47(58.33)
过敏14(31.81)21(55.26)35(41.67)0.032
总计443882
), ArticleFig(id=1311350381460939372, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350372728398329, language=CN, label=表3, caption=

两种喂养方式婴儿过敏性疾病患病率卡方检验

, figureFileSmall=null, figureFileBig=null, tableContent=
组别组别(%)总计P值
母乳喂养组混合喂养组
健康30(68.18)17(44.74)47(58.33)
过敏14(31.81)21(55.26)35(41.67)0.032
总计443882
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分娩方式与喂养方式对生命早期肠道菌群及婴儿过敏的影响
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张伦溥 , 逯畅 , 曾瑶 , 黎晓婷 , 吴华娇 , 黄明豪 , 何方 , 沈曦
现代预防医学 | 营养与食品卫生 2026,53(14): 2581-2587
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现代预防医学 |营养与食品卫生 2026 , 53 (14) : 2581 -2587
分娩方式与喂养方式对生命早期肠道菌群及婴儿过敏的影响
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张伦溥(2000—),男,硕士,研究方向:肠道菌群与健康研究

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张伦溥, 逯畅, 曾瑶, 黎晓婷, 吴华娇, 黄明豪, 何方, 沈曦
作者信息
  • 四川大学华西公共卫生学院(四川大学华西第四医院),四川 成都 610041
通讯作者:
沈曦,E-mail:
作者简介:

张伦溥(2000—),男,硕士,研究方向:肠道菌群与健康研究

The impact of delivery mode and feeding mode on gut microbiota in early life and infant allergies
Lun-pu ZHANG, Chang LU, Yao ZENG, Xiao-ting LI, Hua-jiao WU, Ming-hao HUANG, Fang HE, Xi SHEN
Affiliations
  • West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-07-25 doi: 10.20043/j.cnki.MPM.202601240
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目的

探究生命早期因素对婴儿肠道菌群起始构建的影响,以及其与婴儿期过敏性疾病的关联。

方法

在华西第二医院、成都市妇幼保健院建立的母婴队列中纳入过敏组样本35例和对照组样本47例进行病例对照研究。

结果

顺产组婴儿过敏性疾病发病率(30.30%)低于剖宫产组(51.02%),差异无统计学意义(P=0.063);母乳喂养组发病率(31.81%)低于混合喂养组(55.26%),差异有统计学意义(P=0.032)。在第0天时过敏组Simpson指数高于健康组(P<0.05),在第30天时健康组菌群丰富度相关指数更优。第7天时过敏混合喂养组蛭弧菌门(Bdellovibrionota)高于其他组(P<0.05);健康组第7天时粪便双歧杆菌属(Bifidobacterium)相对丰度高于过敏组(P<0.05),且健康组母乳中双歧杆菌属丰度在0-30天持续高于过敏组。

结论

顺产有益于婴儿早期维持肠道菌群的多样性、构建以双歧杆菌为优势地位的肠道菌群模式,同时母乳喂养也促进双歧杆菌等益生菌定植,进而降低婴儿远期过敏风险。

分娩方式  /  喂养方式  /  生命早期  /  过敏性疾病  /  肠道菌群
Objective

To explore the impact of early life factors on the initial establishment of infant gut microbiota and their association with allergic diseases in infancy.

Methods

A nested case-control study was conducted involving 82 samples from the maternal-infant cohorts established at West China Second University Hospital and Chengdu Women’s and Children’s Central Hospital.

Results

In the vaginal delivery group, the incidence of allergic diseases in infants (30.30%) was lower than that in the cesarean section group (51.02%), with no statistically significant difference; in the breastfeeding group, the incidence (31.81%) was lower than that in the mixed feeding group (55.26%), and the difference was statistically significant (P=0.063; P=0.032). On day 0, the Simpson index in the allergic group was significantly higher than that in the healthy group (P<0.05). By day 30, the healthy group exhibited more favorable microbial richness-related indices of the gut microbiota. On day 7, the relative abundance of Bdellovibrionota in the allergic mixed-fed group was significantly higher than that in other groups (P<0.05). The relative abundance of Bifidobacterium in feces was significantly higher in the healthy group than in the allergic group on day 7 (P<0.05), and the abundance of Bifidobacterium in breast milk of the healthy group remained higher than that of the allergic group from day 0 to day 30.

Conclusion

Vaginal delivery is conducive to maintaining the diversity of gut microbiota in early infancy and establishing a gut microbiota pattern dominated by Bifidobacterium. Meanwhile, breastfeeding promotes the colonization of probiotics such as Bifidobacterium, thereby reducing the long-term risk of allergies in infants.

Delivery mode  /  Feeding mode  /  Early life  /  Allergic diseases  /  Gut microbiota
张伦溥, 逯畅, 曾瑶, 黎晓婷, 吴华娇, 黄明豪, 何方, 沈曦. 分娩方式与喂养方式对生命早期肠道菌群及婴儿过敏的影响. 现代预防医学, 2026 , 53 (14) : 2581 -2587 . DOI: 10.20043/j.cnki.MPM.202601240
Lun-pu ZHANG, Chang LU, Yao ZENG, Xiao-ting LI, Hua-jiao WU, Ming-hao HUANG, Fang HE, Xi SHEN. The impact of delivery mode and feeding mode on gut microbiota in early life and infant allergies[J]. Modern Preventive Medicine, 2026 , 53 (14) : 2581 -2587 . DOI: 10.20043/j.cnki.MPM.202601240
肠道菌群,参与人体营养代谢、免疫调节等重要生理过程,其结构失衡与多种疾病的发生发展密切相关[1]。生命早期是肠道菌群构建的关键窗口期,容易受到多种因素的影响,肠道菌群的紊乱与远期健康结局密切相关。生命早期肠道微生物群的不平衡发展不仅与当前的疾病风险相关,而且在纵向研究中,新生儿期建立的特定模式肠道菌群与未来的健康问题相关。
近年来,过敏性疾病在婴幼儿群体中的发病率逐年上升,已成为全球公共卫生关注的焦点。研究表明过敏婴儿肠道内的双歧杆菌和乳杆菌普遍比正常婴儿少,部分机会致病菌的相对丰度显著增加[2],提示肠道菌群的早期定植异常可能是过敏性疾病发生的重要诱因。
目前,分娩方式和喂养方式被认为是影响生命早期肠道菌群定植和发展的主要影响因素。顺产婴儿通过接触母亲产道和肠道菌群获得初始定植菌群,而剖宫产婴儿则更多暴露于环境菌群,两者的菌群起始来源存在显著差异[3]。对于喂养方式,有研究显示母乳喂养通过母乳低聚糖(HMOs)等生物活性成分促进特定菌群(如双歧杆菌)的生长,而混合喂养(添加配方奶)可能改变菌群的定植轨迹[4]。另有多项研究显示母乳喂养与非母乳喂养个体在婴儿期和成年期的粪便微生物群存在差异,母乳喂养可以预防呼吸道和胃肠道感染以及过敏性疾病[5]。然而,目前关于分娩方式与喂养方式如何通过影响生命早期肠道菌群进而调控婴儿过敏风险的系统性研究仍有待深入。
本文旨在探究分娩方式与喂养方式对生命早期肠道菌群构建的影响,以及后续对婴儿过敏的作用。通过招募母婴出生队列,分析新生儿的初始肠道菌群结构受分娩方式等产时因素的影响;分析母乳菌群,初探产后1月龄内母乳因素对肠道菌群构建的协同影响;分析生命早期肠道菌群起始-构建与婴儿期过敏性疾病发生的关联性。明确分娩方式和喂养方式对生命早期肠道菌群的作用及未来过敏风险的影响,为临床指导产妇选择合理的分娩方式和喂养方式提供理论支持,为开发基于肠道菌群调控的过敏性疾病预防手段奠定基础。
在华西第二医院、成都市妇幼保健院招募、纳入研究对象,建立母-婴出生队列,以孕妇在院为追踪起点,追踪随访收集新生儿产后6月龄内(添加辅食前)的粪便及1月龄内母乳,测定粪便和母乳菌群,进行病例对照研究。以《婴儿过敏性疾病预防、诊断和治疗专家共识》和《过敏性疾病诊疗指南》为参考依据,本研究通过电话随访,详细询问受试婴儿父母其过敏性疾病诊断情况,包括诊断医院、诊断方法、诊断结果等,对受试婴儿进行纳排分组。研究的全部过程均遵循赫尔辛基原则,并由纳入对象的父母签署知情同意书,已由四川大学华西公共卫生学院伦理委员会审查并批准通过(编号:K2021022)。于婴儿6月龄后进行电话访问,依据监护人主诉诊断过敏。具体纳排标准如下:
①婴儿粪便样品采样齐全,特别是第0天粪便;②6月龄回访时家长主诉未发生任何过敏性疾病相关症状。
①婴儿粪便样品采样齐全,特别是第0天粪便;②6月龄回访时家长主诉婴儿确诊过食物过敏、湿疹、过敏性哮喘等任意一种过敏性疾病,并由受试婴儿父母提供县级以上医院的诊断报告或就医病历。
①婴儿患先天缺陷型疾病或急性疾病;②婴儿6月龄以前行肠道侵入性检查或治疗;③婴儿因感染性疾病长期服用抗生素。
采用自行编制问卷调查母亲孕期、婴儿0~1月龄、婴儿2~3月龄、婴儿4~6月龄过敏性疾病相关影响因素,经小样本测试后正式开展调查。
①一般人口学特征:包括婴儿母亲年龄、身高、孕前体重、产前体重、孕期增重情况;婴儿分娩方式、胎龄、性别、出生身长、出生体重等;②行为因素:婴儿母亲孕期吸烟情况、饮酒情况等。
①一般人口学特征:婴儿身长、体重等;②膳食因素:婴儿开奶时间、食用初乳情况、喂养方式、食用母乳时间(天)、食用奶粉时间(天)等;③健康疾病状况:婴儿感染性疾病发生情况及抗生素、益生菌使用情况等。
①一般人口学特征:婴儿身长、体重等;行为因素:婴儿母亲产后吸烟情况、饮酒情况等; ③膳食因素:婴儿喂养情况、婴儿母亲产后各类食物及膳食补充剂食用 情况等;④健康疾病情况:婴儿母亲抗生素使用情况、婴儿感染性疾病及过敏性疾病发生情况、抗生素与益生菌使用情况等。
研究对象采集自然排出的新鲜粪便(约5 g)于 无菌粪样采集管中,在2 h内低温运送至实验室,夜晚采集的粪便暂存于-20 ℃冰箱中并于24 h内低温运送至实验室。①采用天根粪便DNA提取试剂盒提取粪便DNA;②采用实时荧光定量qPCR技术对各菌种进行绝对定量;③采用GC-MS检测粪便中SCFAs含量。
研究对象采集母乳样本与无菌采集管,2 h内低温运送至实验室。
所有调查员需进行统一培训,考核通过才能进行问卷调查;研究人员每天审核当日完成的问卷,筛选并剔除出信息不合理或不完整的问卷。
体格测量前请专业人员校正仪器,每项测量项目均由同种仪器完成;所有测量人员需经过统一培训,测量过程需严格遵循标准流程。
对研究对象进行详尽说明,及时联系,严格控制粪便样本采集方法及样本回收时间;粪便样本运输过程保持4 ℃左右,避免污染和降解,样本送至实验室后做好标记和分装,立即冻存至-80 ℃冰箱;血液样本由专业医护人员在指定采血点采集,血液样本室温下4 h内检测并分装,剩余样本立即冻存于-80 ℃冰箱。
问卷调查和体格测量数据用Epidata进行双人双录入,及时复查错误数据,确保资料的完整性及准确性。
采用SPSS 27.0软件。正态分布的连续变量以均值±标准差()表示,两组之间比较采用t检验;非正态分布的连续变量以中位数(四分位数)表示,两组之间比较采用非参数检验。计数资料以百分率(%)表示,两组之间比较采用χ2检验。检验水准α=0.05。
根据受试者的问卷调查结果、粪便样本采集情况,并结合纳排标准整理后,本研究从200例母婴对中纳入82例婴儿。82名婴儿完成了1个月的随访调查并收集了其出生后第0、7、30天共3个时间点的粪便样本。依据诊断标准进行疾病分组,35例曾患过过敏性疾病的婴儿组成过敏组,47例健康婴儿组成健康组。在以疾病分组基础上,根据受试者的问卷调查结果,按分娩方式再分组,得到过敏-顺产(A-VD)婴儿10名,过敏-剖宫产婴儿(A-CS)25名,健康-顺产(NA-VD)婴儿23名,健康-剖宫产(NA-CS)婴儿24名,共婴儿82名。按90天内纯母乳喂养大于等于80天为母乳喂养,其余为混合喂养进行分组,得到过敏-母乳喂养婴儿(A-BF)14名,过敏-混合喂养婴儿(A-MF)21名。健康-母乳喂养婴儿(NA-BF)30名,健康-混合喂养婴儿(NA-MF)17名,共婴儿82名。但由于样品采集过程中的缺失,实际进行测序的样品数量见表1。
对不同分娩方式和喂养方式婴儿过敏性疾病发病率进行卡方检验,结果见下表2、表3。对于分娩方式,顺产组婴儿过敏性疾病的发病率低于剖宫产组(30.30%<51.02%),母乳喂养组婴儿过敏性疾病的发病率低于混合喂养组(31.81%<55.26%)。根据检验结果可得,剖宫产与顺产的婴儿过敏性疾病患病率差异无统计学意义(P=0.063,χ2=3.47);母乳喂养与混合喂养的婴儿过敏性疾病患病率差异有统计学意义(P=0.032,χ2=4.58)。
对收集的婴儿0、7、30天共3个时间点的粪便样品及0、30天2个时间点的母乳样品做菌群多样性分析。健康与过敏两组婴儿0天肠道菌群在Simpson指数上差异有统计学意义(P<0.05,t=2.967),其余各个时间点的ACE、Chao1、Shannon和Simpson指数均无统计学差异(P>0.05),见图1。从时间变化上看,健康组从第0天到第30天反应物种丰富度的指数水平下降趋势较为一致,过敏组第0天至第7天下降较快,第7天至第30天下降速度与健康组相近,两组时间变化趋势的差异有统计学意义。随时间变化,过敏组的Shannon指数从第0天至第30天成持续下降趋势,健康组的Shannon指数从第0天到第7天呈上升趋势,第7 天到第30天呈下降趋势,两组时间变化趋势的差异有统计学意义(P<0.05),具体见图2。在第0天母乳菌群中,健康组的Shannon、Simpson指数均高于过敏组(P1<0.05,t1=3.172,P1<0.05,t2=2.809),健康组在第0天的母乳群落丰富度显著高于过敏组,见图3。其他指标差异无统计学意义。
不同时间点各组婴儿粪便和母乳菌群在门水平上的优势菌组成为Firmicutes(厚壁菌门)、Proteobacteria(变形菌门)、Actinobacteriota(放线菌门)和Bacteroidota(拟杆菌门)组成。第30天婴儿粪便中,过敏组中发现比健康组更高比例的Bacteroidota(P<0.05,t=2.282),见图4。按疾病喂养方式分组,第7、30天,过敏混合喂养组婴儿粪便中Bdellovibrionota(蛭弧菌门)显著高于其他三组(P<0.05,F=3.913),见图5。其他分组指标差异无统计学意义。
从时间层面来看,过敏组和健康组中Firmicutes在第0天表现出较高水平的相对丰度,在第0天至第30天呈持续下降趋势;Proteobacteria在第0天相对丰度较低,健康组在第0天至第30天相对丰度呈持续上升趋势,过敏组呈现“先升高后下降”趋势;Acidobacteriota 在两组间随时间变化趋势相同,均为“先下降后升高”,具体见图6。在疾病-分娩方式分组中,剖宫产两组Firmicutes起始相对丰度高于顺产组整体,除过敏顺产组在第0天至第7天呈上升趋势,其余各组各时间点均为下降趋势;Proteobacteria 的相对丰度在过敏-顺产组中的第0天至第7天、健康-顺产组的第7天至第30天出现下降趋势,其余各组各时间点均为上升趋势,见图7。
在属水平层级上观察婴儿肠道菌群物种相对丰富度,健康组在第7天时检出更高比例的Bifidobacterium(P<0.05,t=2.051),见图8。从时间层面上看,Bifidobacterium在两组间呈“下降后上升”趋势,健康组整体高于过敏组,见图9。在疾病-分娩方式分组中,Bacteroides(拟杆菌属)在顺产两组中相对丰度与剖宫产两组差异较大,顺产两组中Bacteroides 整体相对丰度在第0天至第30天整体高于剖宫产两组,剖宫产两组在期间相对丰度始终在较低水平,具体见图10。其他分组指标差异无统计学意义。
在属水平层级上观察母乳菌群物种相对丰富度,按疾病分组,在第0天的母乳中过敏组中Bacteroides 的相对丰度高于健康组(P<0.05,t=2.945),Bifidobacterium的相对丰度低于健康组(P<0.05,t=2.168),见图11。按疾病-分娩方式分组,在第0天健康-顺产组中的Bifidobacterium高于剖宫产两组(P<0.05,t=2.945),见图12。从时间层面上看,健康组母乳中双歧杆菌的相对丰度在0-30内一直高于过敏组,见图13。其他分组指标差异无统计学意义。
本研究从招募的母婴队列中,纳入符合标准的母婴,对婴儿粪便菌群和母乳菌群分析,探究分析新生儿的初始肠道菌群结构受分娩方式等产时因素的影响以及生命早期肠道菌群起始-构建与婴儿期过敏性疾病发生的关联性。研究发现分娩方式和喂养方式可能会影响生命早期婴儿肠道菌群的构建,包括肠道菌群的Alpha多样性以及各菌群的相对丰度;顺产以及母乳喂养的婴儿其肠道菌群的构建模式,更有利于婴儿远期健康,降低其患过敏性疾病的风险。
有研究认为,不同分娩方式导致婴儿肠道菌群在刚出生时存在较小差异,但在其他因素相同的条件下,两种出生方式的婴儿肠道菌群差异会逐渐缩小[6]。而喂养方式不同导致的肠道菌群差异可能持续时间更长[7]。本研究过敏组0天肠道菌群的Alpha多样性指数高于健康组,而后逐渐低于健康组,这可能与出生时的分娩方式和后续喂养方式有关。从分娩方式来看,在疾病-分娩方式分组中,剖宫产两组Firmicutes起始相对丰度高于顺产组整体,顺产两组中Bacteroides整体相对丰度在第0天至第30天整体高于剖宫产两组,剖宫产两组在期间相对丰度始终在较低水平。这与既往研究结果一致,顺产婴儿通过产道时接触母亲阴道菌群(以乳酸杆菌为主),快速建立以双歧杆菌和拟杆菌为优势的菌群[8],而剖宫产婴儿由于缺乏产道接触,其菌群更接近母亲皮肤菌群(如葡萄球菌、丙酸杆菌)或医院环境中的菌群[9]。剖宫产婴儿肠道菌群多样性显著低于顺产婴儿,且双歧杆菌丰度较低,这可能与其过敏风险增加相关。从喂养方式分析,按疾病-喂养方式分组,第 7、30 天,过敏混合喂养组婴儿粪便中Bdellovibrionota显著高于其他三组。目前对于Bdellovibrionota的研究较少,少数研究发现,肠道中Bdellovibrionota的丰度变化可能与炎症性肠病(IBD)、肥胖等疾病相关,但具体机制尚不明确[10]。还有研究认为Bdellovibrionota通过捕食革兰氏阴性病原菌(如大肠杆菌、沙门氏菌、志贺氏菌等)直接减少肠道内的病原菌,降低感染发生的风险。
本研究发现,在婴儿肠道菌群的Alpha多样性分析中发现,过敏组和健康组婴儿肠道菌群ACE和Chao1指数随时间变化存在差异,过敏组两个菌群丰富度指数第0天时高于健康组,后续第30天时低于健康组。曾有研究发现,出生至5岁发生过敏的儿童在1岁时肠道微生物组的Alpha多样性明显低于健康儿童,另有研究也认为肠道菌群多样性下降可能与婴儿过敏性疾病相关[11]。这与本研究中30天时婴儿肠道菌群Alpha多样性表现一致。在属水平层级上,按疾病分组,在第0天的母乳中过敏组Bacteroides的相对丰度显著高于健康组,Bifidobacterium 的相对丰度显著低于健康组。从时间层面上看,健康组母乳中双歧杆菌的相对丰度在0~30天内一直高于过敏组。已有研究证实,母乳不仅是营养来源,更是婴儿肠道菌群的“种子库”,母乳中的益生菌(如双歧杆菌、乳酸杆菌等)通过抑制有害菌、促进肠道屏障功能和免疫调节,降低感染和过敏风险[12]。还有研究发现,高丰度的双歧杆菌通过竞争性排斥致病菌、增强紧密连接蛋白表达,降低肠道通透性,减少过敏原及病原体易位至循环系统[13]。母乳低聚糖(HMO)可选择性促进双歧杆菌增殖,同时抑制致病菌的定植[4]。本研究中过敏的发生很可能与健康组和过敏组中双歧杆菌的差异有关。
综合来看,分娩方式和喂养方式通过影响婴儿肠道菌群的组成和动态变化,进而可能对婴儿过敏性疾病产生作用。分娩虽然影响肠道菌群起始,但随时间推移各组婴儿肠道菌群结构近似,喂养方式对肠道菌群构建的影响更为持续。肠道菌群在免疫调节、肠道屏障功能、抗原识别和耐受以及代谢产物等方面对免疫系统有着重要影响。当肠道菌群失衡时,可能导致免疫系统失调,增加过敏发生的风险。本研究在分析婴儿过敏的影响因素时,同时分析婴儿粪便菌群与母亲母乳菌群的动态变化,同时通过“疾病-分娩-喂养”的多维分组方式揭示了生命早期分娩方式和喂养方式对婴儿过敏的作用,并分析其复杂的交互作用。
综上所述,分娩方式和喂养方式在婴儿肠道菌群建立过程中扮演着关键角色,并且与婴儿过敏情况存在紧密关联。分娩方式与婴儿出生时肠道菌群多样性以及婴儿生命早期肠道菌群的构建存在关联,顺产可能有益于婴儿早期维持肠道菌群的多样性、构建以双歧杆菌为优势地位的肠道菌群模式;早期的母乳喂养可能参与婴儿早期肠道菌群模式的构建,母乳菌群的定植会增加肠道菌群的多样性,而母乳中的母乳低聚糖可以促进肠道菌群中优势菌如双歧杆菌的生长。建立的以双歧杆菌为优势菌的肠道菌群模式可以降低婴儿未来过敏疾病的风险。剖宫产和混合喂养或导致菌群失衡增加过敏易感性,可为临床制定婴儿过敏预防策略提供理论依据。
未来研究可进一步探讨特定菌群(如双歧杆菌)的功能机制,以及通过益生菌干预调节菌群以预防过敏的可行性。临床实践中,可以进一步深入探究如何通过优化分娩方式后的干预措施以及合理调整喂养策略,来塑造更有利于降低过敏风险的婴儿肠道菌群结构,制定个性化的过敏预防策略,为降低婴儿过敏发生率提供新的思路,为预防和控制婴儿过敏性疾病提供更有力的科学依据。
本研究为跨横跨一定时间的病例对照研究,在研究中存在一定的局限性。(1)本研究最终纳入的样本量为82例,样本量相对较小,可能影响统计效能;(2)过敏诊断基于家长主诉和医院记录,虽经核实,但仍存在回忆偏倚可能;(3)过敏诊断并未严格遵循指南要求,存在偏倚;(4)观察期为婴儿早期(0-30天)和6月龄随访,未能追踪更远期的过敏结局。
  • 国家自然科学基金青年基金项目(82003453)
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2026年第53卷第14期
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doi: 10.20043/j.cnki.MPM.202601240
  • 接收时间:2026-01-15
  • 首发时间:2026-09-28
  • 出版时间:2026-07-25
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  • 收稿日期:2026-01-15
基金
国家自然科学基金青年基金项目(82003453)
作者信息
    四川大学华西公共卫生学院(四川大学华西第四医院),四川 成都 610041

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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