危重症肠黏膜屏障功能障碍的机制研究

Mechanism of the Intestinal Mucosal Barrier Dysfunction in Patients with Critical Illness Patients

肠黏膜具有选择性渗透吸收营养物质和防御肠道内微生物及致炎因子入侵等屏障功能。在正常情况下肠道屏障功能使细菌和内毒素局限在肠道内，防止机体受内源性微生物及其毒素的侵害。在严重感染、创伤、手术、休克、重症胰腺炎等应激状态或长期进行肠外营养的情况下，肠黏膜发生缺血缺氧损伤，其结构和功能可能受到严重损害，导致肠黏膜屏障功能障碍，发生肠道细菌易位，引起全身炎性反应综合征甚至诱发多脏器功能衰竭而危及生命。因此，肠屏障功能已成为判断危重患者预后的重要指标之一，了解肠屏障功能损伤的机制对于防治多脏器功能衰竭有重要的临床意义。

Intestinal mucosa has such barrier function as absorbing nutrients selectively and intestinal microbial defense and invasion of proinflammatory factors. Under normal circumstances the barrier function of intestine confines bacteria and endotoxin to the intestine to prevent the body from the attack of endogenous micro-organisms and their toxins. In such stress as severe infection, trauma, surgery, shock, severe pancreatitis and long-term parenteral nutrition,ischemia and hypoxia injury occurs to intestinal mucosal, and its structure and function may be damaged ,resulting in intestinal mucosal barrier dysfunction, the occurrence of intestinal bacterial translocation, systemic inflammatory response syndrome even multiple organ failure and life-threatening. Therefore, the gut barrier function has become one of the important indicators to determine the proguosis of patients. It is an important clinical significance to understand the mechanism of intestinal barrier dysfunction to the prevention and control of multiple organ dysfunction.