肝移植术后肠道菌群失调的诊疗策略  

Diagnosis and treatment strategy of intestinal flora imbalance after liver transplantation

作　　者：鲍志野[1] 刘浩[2] Bao Zhiye;Liu Hao(Department of Organ Transplantation and Hepatobiliary Surgery,the First Hospital of China Medical University,Key Laboratory of Organ Transplantation of Liaoning Province,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院器官移植暨肝胆外科辽宁省器官移植重点实验室,沈阳110001 [2]中国医科大学附属盛京医院肝胆移植外科

出　　处：《器官移植》2022年第4期469-474,共6页Organ Transplantation

基　　金：国家自然科学基金项目(81373173)。

摘　　要：肝移植术后会发生多种近期以及远期并发症。在术后早期,由于多重耐药菌的产生很容易导致各种感染,其中之一表现为肠道菌群失调。在过去的十年中,一系列研究发现肠道菌群在维持肠道稳态方面具有重要功能。肠道菌群通过多种途径与其他器官相互影响,其中肠肝轴是最关键的体内微环境调节通道之一。肠道菌群在数量和成分上的改变均能导致肠道菌群失调。无论在局部还是全身系统,肠道菌群与免疫系统都存在广泛的交互作用。本文着重探讨肝移植术后肠道菌群失调发生的危险因素、肠道菌群失调对肝移植受者的影响以及相关的治疗方案。Multiple short-term and long-term complications might occur after liver transplantation.In the early stage after liver transplantation,the incidence of multidrug-resistant bacteria is likely to cause different types of infection,one of which is intestinal flora imbalance.In the recent decade,a series of studies have demonstrated that intestinal flora plays an important role in maintaining intestinal homeostasis.Intestinal flora may interact with other organs via multiple patterns.Among which,gut-liver axis is one of the most critical channels for regulating microenvironment of the host.Changes in the quantity and composition of intestinal flora could lead to intestinal flora imbalance.In both local and systemic systems,extensive interaction exists between intestinal flora and immune system.In this article,the risk factors of intestinal flora imbalance after liver transplantation,influence of intestinal flora imbalance on liver transplant recipients and relevant treatment strategies were reviewed.

关 键 词：肝移植 肠道菌群失调 益生菌 粪便菌群移植 短链脂肪酸 SHANNON多样性指数 全肠外营养(TPN) 选择性消化道去污(SDD) 

分 类 号：R617[医药卫生—外科学] Q939.121[医药卫生—临床医学]