应激对肠屏障功能的影响

Stress and intestinal barrier function

肠屏障功能是肠道的一个重要特征 ,正常肠屏障功能的维持依赖于肠粘膜上皮、肠道内正常菌群、肠道内分泌物、蠕动、肠相关免疫细胞等 ,其中最关键的屏障是肠粘膜上皮屏障。在创伤、严重感染、缺血、饥锇等应激状态下 ,肠屏障功能将发生一系列病理生理的变化 ,导致肠粘膜萎缩及通透性增大。应激下肠屏障功能改变的机制是多因素的 ,没有哪一种单一机制能解释肠屏障功能不全的所有方面。作者就应激时肠屏障功能变化的机制作一综述。

The barrier function is an important characteristic of the gut and an important determinant in the outcome of critically ill patients. Its workings are complex and it consists of epithelial, molecular, and immune components. The pathogenesis of gut dysfunction among critically ill patients is multifactorial. The purpose of this literature review is to provide a better understanding of the normal defense mechanisms of the gut, alterations associated with ischemia reperfusion injury, risk of infection, starvation and malnutrition and severe trauma, and potential therapies for gut dysfunction in critically ill patients.