梗阻性黄疸中的加速康复外科:胆汁酸和肠道微生物的代谢相互作用

Accelerated rehabilitation surgery in obstructive jaundice: metabolic interactions between bile acids and intestinalmicrobes

梗阻性黄疸具有疾病进展迅速、并发症多和住院时间长的特点。治疗该疾病的主要手段是解除梗阻。肝功能从梗阻解除后开始恢复,但恢复的过程相对漫长,胆汁酸可以作为肝功能恢复的一项指标。胆汁酸是胆汁的主要成分之一,承担消化、信使的功能。基于肝胆系统和肠道相连的特殊解剖结构,胆汁酸与肠道微生物还有千丝万缕的关系。尽管关于胆汁酸和肠道微生物的研究已有几十年的历程,但对其具体相互作用和生物学功能尚不完全清楚。在这篇综述中,着重描述了胆汁酸的代谢过程,并且强调了胆汁酸是如何被肠道微生物群调控的机制,即肠道微生物如何通过代谢能力影响胆汁酸的组成,以及外部因素如何影响肠道微生物群从而影响胆汁酸组成。这些机制产生了针对肠道微生物群和胆汁酸代谢紊乱的治疗方法并促进了梗阻性黄疸术后加速康复。

Obstructive jaundice is characterized by rapid disease progression,more complications and long hospital stay.The main treatment for the disease is to remove the obstruction.The recovery of liver function begins after the obstruction is relieved,but the recovery process is relatively long,and bile acids can be used as an indicator of the recovery of liver function.Bile acid is one of the main components of bile,which is responsible for digestion and messenger function.Bile acids are also closely related to gut microbes,based on the particular anatomy of the hepatobiliary system connected to the gut.Although bile acids and gut microbes have been studied for decades,their specific interactions and biological functions are not fully understood.In this review,the metabolic process of bile acids is mainly described,and the mechanism of how bile acids are regulated by intestinal microbiome is emphasized,that is,how intestinal microorganisms affect bile acid composition through metabolic capacity,and how external factors affect intestinal microbiome and thus bile acid composition.These mechanisms have led to therapies targeting intestinal microbiome and bile acid metabolism disorders and accelerated postoperative recovery from obstructive jaundice.