酒精性肝病与肠道微生态的研究进展

Alcoholic liver disease and intestinal microecology

酒精性肝病(alcoholic liver disease, ALD)是由于长期大量饮酒所致的肝损害,以肝细胞脂肪变性和脂肪贮积为主要特征,疾病谱包括脂肪肝、酒精性肝炎、酒精性肝纤维化和酒精性肝硬化,其中脂肪肝及早期酒精性肝炎在戒酒后可逆转. ALD的发病机制尚未完全明了,研究认为,肠道微生态失衡与ALD的发生发展密切相关.慢性酒精摄入可通过影响肠道黏膜通透性、肠道菌群失调、细菌移位等方式引起肠道微生态失衡,进而激活机体免疫应答,诱导肝脏产生炎性反应而造成肝损伤.基于此,临床可通过补充益生菌或益生元、合理应用抗生素及粪菌移植等方式调节肠道菌群失调,从而达到治疗的目的,此外,针对肠道微生态失衡的靶向治疗亦成为目前的研究热点.

Alcoholic liver disease(ALD)is damage to the liver that occurs after excessive alcohol use over a long period of time,which is mainly characterized by hepatocyte steatosis and fat storage,and the disease spectrum includes steatosis,steatohepatitis,alcoholic fibrosis,and cirrhosis.Steatosis and early steatohepatitis are reversible after cessation of alcohol use.Although the pathogenesis of ALD is not yet fully understood,many studies have shown that the intestinal microecological dysbiosis is closely related to the occurrence and development of ALD.Chronic alcohol use may cause intestinal microecological dysbiosis by leading to increased intestinal mucosal permeability,intestinal flora imbalance,and bacterial translocation,which can then activate immune response,induce an inflammatory response in the liver,and thus lead to liver damage.Based on this situation,we can adjust the intestinal flora imbalance to achieve the goal of treating ALD by using various methods such as supplementing probiotics or prebiotics,properly using antibiotics,and performing fecal microbiota transplantation.In addition,targeted therapy for intestinal bacterial imbalance has also become a hotspot in current research.