目的　探讨早产儿坏死性小肠结肠炎（NEC）发病的危险因素。方法　以双胎配对为基础，回顾分析2012年1 月1日至2018年12月31日出生、仅1胎患NEC早产双胞胎的临床资料，比较NEC组与对照组之间的基本资料（出生体质量、 产时窒息、出生顺序、性别）、危险因素（喂养情况、治疗措施、疾病状态）。 结果　NEC组发生喂养不耐受的比例高于对照 组，发病前48小时内浓缩红细胞输注比例高于对照组，生后1周内血红蛋白最低值、起病前最后一次输浓缩红细胞当日血 红蛋白水平低于对照组，差异均有统计学意义（P<0.05）。 条件logistic回归分析显示，喂养不耐受（P=0.018，OR=7.26， 95%CI：1.40~37.77）、早期贫血（P=0.022，OR=10.21，95%CI：1.41~74.01）、NEC发病前48小时内浓缩红细胞输注（P=0.023， OR=16.65，95%CI：1.47~188.09）为NEC发病的独立危险因素。结论　喂养不耐受、早期贫血、NEC发病前48小时内浓 缩红细胞输注与NEC发病相关。

　Objective　To analyze the risk factors of neonatal necrotizing enterocolitis (NEC) in twins. Methods　Medical records of twins, of which only one suffered from NEC charged in Xiangya Hospital between 2012 and 2018 were retrospectively reviewed. The enrolled twins were divided into NEC group and non-NEC group. The potential risk factors of NEC including basic information (birth weight, asphyxia after birth, birth order, gender) and risk factors (enteral feeding, medical treatments, relevant diseases) were compared between the two groups. Results　The rate of feeding intolerance (65.9% vs. 40.9%, χ2=5.526, P=0.019), red cell concentration by infusion within 48 hours before NEC occurred (27.3% vs. 6.8%, χ2=6.510, P=0.011) were significantly higher in twins with NEC than those without NEC. The lowest hemoglobin content in the first week after birth (114.9±19.5 g/L vs. 127.7±24.0 g/L, P<0.001) were significantly lower in twins with NEC than those without NEC. Conditional logistic regression analysis showed that the independent risk factors of NEC were feeding intolerance (P=0.018, OR=7.264, 95%CI:1.397~37.766), early anemia (P=0.022, OR=10.208, 95%CI:1.408~74.009) and red cell concentration by infusion within 48 hours before NEC occurred (P=0.023, OR=16.648, 95%CI: 1.473~188.094). Conclusions　Feeding intolerance, early anemia and red cell concentration by infusion within 48 hours before NEC occurred were independent risk factors of NEC.