“肠道菌群-炎症反应”在肝性脑病中研究进展

Research progress on the"intestinal microflora-inflammatory response"in hepatic encephalopathy

肝性脑病是由严重的肝功能障碍和(或)门-体静脉分流导致的神经精神异常综合征,发病机制尚未明了,与氨中毒、炎症反应、氧化应激、肠道菌群紊乱、神经递质改变等相关。近年来研究表明肠道菌群失调引起的炎症反应,损伤中枢神经系统;发现益生菌制剂、抗生素、粪菌移植等治疗方法可以改善机体的炎症状态,延缓疾病进展。该综述旨在对肠道菌群与炎症反应在肝性脑病发病中的作用、二者的关系及治疗进行阐述,以期为肝性脑病的治疗提供一定的理论依据。

Hepatic encephalopathy is a neuropsychiatric syndrome caused by severe liver dysfunction and/or portal-systemic venous shunt.The pathogenesis is unclear and is related to ammonia toxicity,the inflammatory response,oxidative stress,intestinal flora disorders,and neurotransmitter changes.Recent studies have shown that the inflammatory response caused by dysbiosis of the intestinal flora damages the central nervous system,leading to clinical symptoms.It has been found that probiotic preparations,antibiotics,fecal bacteria transplantation and other therapeutic approaches can improve the inflammatory state of the body and delay disease progression.This review aims to elaborate the role of intestinal flora and inflammatory response in the pathogenesis of hepatic encephalopathy and the relationship between the two and treatment to provide a certain theoretical basis for the treatment of hepatic encephalopathy.