肠内营养对神经危重症患者肠道微生态影响的研究进展

Research progress of the effect of enteral nutrition on intestinal microecology in neurocritical ill patients

肠道微生态系统是由肠道菌群及其所寄居的肠道环境所组成。神经危重症患者的肠道微生态系统存在严重紊乱,表现为菌群多样性下降、有害菌属及肠屏障破坏增加。适宜的肠内营养可维持肠屏障稳定,调节肠道免疫功能,抑制肠道炎症,还可调节特定肠道菌群及肠道功能,对维持肠道微生态平衡、减少患者临床并发症有着重要的意义,也是神经危重症患者治疗的新靶点。本文概述了神经危重症患者的肠道微生态变化及目前肠内营养指南推荐的治疗方案,将肠内营养及不同添加剂对肠道菌群、肠道功能影响的研究进展进行总结,为后续研究提供参考。

The intestinal flora and the intestinal environment in which it resides together constitute the intestinal microecosystem,it is significantly disturbed in neurocritical ill patients,as manifested by the decrease of bacterial diversity,an increase of pathogen,and the destruction of the intestinal barrier.Appropriate enteral nutrition is effective in maintaining intestinal barrier stability,regulating intestinal immune function,inhibiting intestinal inflammation,and regulating specific intestinal microbiota and intestinal function.It is important for sustaining intestinal microecological balance,reducing clinical complications in patients,and is a new target for the treatment of neurocritical ill patients.This review elaborates the alteration of intestinal microecology and treatment options recommended by current clinical guidelines in neurocritical ill patients and summarizes the research progress of the effects of enteral nutrition and several nutritional additives on intestinal flora and intestinal functions,to provide a reference for the follow-up research.