菌群移植适应证的选择和临床应用策略

Indication selection and clinical application strategies of fecal microbiota transplantation

菌群移植(FMT)已成为治疗复发性艰难梭菌感染的有效手段,除此之外,在其他肠道及肠外疾病的治疗尝试中也显示出一定的效果,大量临床试验相继开展。关于FMT具体方法尚缺乏统一标准。本文从FMT适应证、供体筛选、菌液质量控制、FMT方法学、随访及疗效判断、不良反应处理以及伦理监管等方面,针对FMT目前存在的热点与争议问题,并结合本团队临床治疗经验做综合介绍。

Fecal microbiota transplant(FMT)has become an effective method for the treatment of recurrent C.difficile infection.In addition,it has shown certain effects in other diseases inside and outside the intestine.A large number of clinical trials have been carried out.However,there is still lack of uniform standard for strategies of FMT.In this paper,we discussed the current hot and controversial issues of FMT from the aspects of indication,donor screening,fecal suspension quality control,methodology,follow-up and efficacy judgment,treatment of adverse reaction and ethical supervision based on our team's clinical experience.