胆汁酸与肠道菌群互作在胆汁淤积发病和治疗中的作用  

Role of bile acids-gut microbiota interaction in the pathogenesis and treatment of cholestasis

作　　者：唐银佩 朱正望(综述) 朱平生 蔡庆春[2] 王兵(审校) Tang Yinpei;Zhu Zhengwang;Zhu Pingsheng;Cai Qingchun;Wang Bing(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450046;The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003;Shanghai Jiaotong University School of Medicine Affiliated Sixth People′s Hospital,Shanghai 200240)

机构地区：[1]河南中医药大学第一临床医学院,郑州450046 [2]河南中医药大学第三附属医院,郑州450003 [3]上海交通大学医学院附属第六人民医院,上海200240

出　　处：《安徽医科大学学报》2025年第3期578-583,共6页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金项目(编号:82074340);河南省“双一流”创建学科中医学科学研究专项项目(编号:HSRP-DFCTCM-2023-1-19);上海市2023年度“科学与创新行动计划”自然科学基金面上项目(编号:23ZR1448400)。

摘　　要：胆汁淤积可见于多种急慢性肝病,若不及时干预,持续胆汁淤积可进一步发展为肝纤维化、肝硬化、肝衰竭甚至死亡。胆汁淤积发病机制复杂,目前缺乏有效的治疗药物。胆汁中主要成分胆汁酸(BAs)在肝脏中由胆固醇合成为初级胆汁酸,通过肝肠循环进入肠道后由肠道菌群重塑为次级胆汁酸,BAs可直接或间接影响肠道菌群的组成和功能,肠道菌群可调节BAs的合成及代谢,BAs与肠道菌群互作在胆汁淤积发病和治疗中具有重要作用。该文对BAs与肠道菌群间双向调控机制及其在胆汁淤积发病和治疗中的作用进行阐述,为胆汁淤积相关疾病的基础研究及临床实践提供思路和参考。Cholestasis can be seen in many acute and chronic liver diseases.If not intervened in time,persistent cholestasis can further progress to liver fibrosis,liver cirrhosis,liver failure,and even death.The pathogenesis of cholestasis is complex,and there is currently a lack of effective therapeutic drugs.Bile acids(BAs),the main component of bile,are synthesized from cholesterol in the liver as primary bile acids.After entering the intestine through the enterohepatic circulation,they are reshaped into secondary bile acids by gut microbiota.BAs can directly or indirectly affect the composition and function of gut microbiota,which in turn can regulate the synthesis and metabolism of BAs.The interaction between BAs and gut microbiota plays an important role in the pathogenesis and treatment of cholestasis.This review elucidates the bidirectional regulatory mechanisms between BAs and gut microbiota and their roles in the pathogenesis and treatment of cholestasis,aiming to provide insights and references for basic research and clinical practice related to cholestasis-associated diseases.

关 键 词：胆汁淤积 胆汁酸 肠道菌群 肝肠循环 相互作用 机制 

分 类 号：R257[医药卫生—中医内科学]