目的探討腸道細菌移位研究的進展。
方法復習2000年至2005年6月關(guān)于腸道通透性的改變、腸道菌群失調(diào)和全身炎癥反應綜合征(SIRS)的文獻。
結(jié)果隨著對SIRS和MODS的深入研究,越來越多的證據(jù)顯示,腸道不僅是MODS的靶器官,更是始動器官。只有保證了腸道黏膜屏障的完整性,才能有效的預防腸道細菌移位。去除原發(fā)病,保證腸道的血供和氧供是最基本的治療方法。早期啟動腸道、建立腸內(nèi)營養(yǎng)以及選擇性的腸道去污染也是有效的治療手段。
結(jié)論隨著對腸道細菌移位認識的深入,我們的治療手段不斷豐富,可以更有效預防腸道細菌移位的發(fā)生,并阻止向SIRS和MODS進一步發(fā)展。
引用本文: 肖菲,康焰. 腸道細菌移位的研究現(xiàn)狀. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(2): 240-243. doi: 復制
版權(quán)信息: ?四川大學華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編
1. | [J]. Am J Surg, 2003; 186(3)∶301. |
2. | [J]. Folia Med (Plovdiv), 2005; 47(1)∶11. |
3. | [J]. Ir J Med Sci, 2003; 172(1)∶7. |
4. | 尹軍霞, 林德榮. 腸道菌群與疾病 [J]. 生物學通報, 2004; 39(3)∶26. |
5. | 董永綏. 腸道菌群失調(diào)、內(nèi)毒素與小兒胃腸功能障礙 [J]. 中國實用兒科雜志, 2001; 16(1)∶5. |
6. | Besselink MG, Timmerman HM, Buskens E, et al. Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a doubleblind, placebocontrolled randomised multicenter trial [J]. BMC Surg, 2004; 4(1)∶12. |
7. | 吳國豪. 腸道屏障功能 [J]. 腸外與腸內(nèi)營養(yǎng), 2004; 11(1)∶44. |
8. | 李志軍, 湯日波, 張萬祥. 腸道屏障功能損害與SIRS/MODS的發(fā)生及其防治 [J]. 中國危重病急救醫(yī)學, 2000; 12(12)∶766. |
9. | Demling RH. The clinical relevance of defining the mechanism for altered gut permeability in a “twohit”model of injury and infection [J]. Crit Care Med, 2004; 32(11)∶2356. |
10. | Choudhry MA, Rana SN, Kavanaugh MJ. Impaired intestinal immunity and barrier function: a cause for enhanced bacterial translocation in alcohol intoxication and burn injury [J]. Alcohol, 2004; 33(3)∶199. |
11. | 常建星.全身炎癥反應綜合征與腸屏障的損害 [J]. 國外醫(yī)學·外科學分冊, 2004; 31(3)∶158. |
12. | 張良成. 創(chuàng)傷和失血性休克后腸道屏障功能不全及其與MODS發(fā)生的關(guān)系 [J]. 國外醫(yī)學·麻醉學與復蘇分冊, 2001; 22(4)∶237. |
13. | Berg RD, Garlington AW. Transplantation of certain indigenous from the gastrointerstinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model [J]. Infect Immun, 1979; 23(2)∶403. |
14. | 石剛. 腸道黏膜屏障的損傷與保護 [J]. 腸外與腸內(nèi)營養(yǎng), 2004; 11(1)∶61. |
15. | DeSouza DA, Greene LJ. Intestinal permeability and systemic infections in critically ill patients: effect of glutamine [J]. Crit Care Med, 2005; 33(5)∶1125. |
16. | Ding LA, Li JS. Gut in diseases: physiological elements and their clinical significance [J]. World J Gastroenterol, 2003; 9(11)∶2385. |
17. | Steinberg SM. Bacterial translocation: what it is and what it is not. |
18. | Luyer MD, Buurman WA, Hadfoune M, et al. Strainspecific effects of probiotics on gut barrier integrity following hemorrhagic shock [J]. Infect Immun, 2005; 73(6)∶3686. |
19. | 鄭躍杰, 段恕誠. 微生態(tài)失衡與內(nèi)源性感染 [J]. 中國實用兒科雜志, 2003; 18(5)∶302. |
20. | Lichtman SM. Bacterial [correction of baterial] translocation in humans [J]. J Pediatr Gastroenterol Nutr, 2001; 33(1)∶1. |
21. | 趙光俠. 胃腸道細菌移位、 胃液菌群變化與全身炎癥反應綜合征 [J]. 小兒急救醫(yī)學, 2003; 10(3)∶184. |
22. | Stefanov CS, Boyadzhiev NP, Uchikov AP. Enteral nutrition in sepsis patients. |
23. | Kell MR, Barry BD, Redmond HP. Systemic inflammatory response syndrome: a new direction?. |
- 1. [J]. Am J Surg, 2003; 186(3)∶301.
- 2. [J]. Folia Med (Plovdiv), 2005; 47(1)∶11.
- 3. [J]. Ir J Med Sci, 2003; 172(1)∶7.
- 4. 尹軍霞, 林德榮. 腸道菌群與疾病 [J]. 生物學通報, 2004; 39(3)∶26.
- 5. 董永綏. 腸道菌群失調(diào)、內(nèi)毒素與小兒胃腸功能障礙 [J]. 中國實用兒科雜志, 2001; 16(1)∶5.
- 6. Besselink MG, Timmerman HM, Buskens E, et al. Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a doubleblind, placebocontrolled randomised multicenter trial [J]. BMC Surg, 2004; 4(1)∶12.
- 7. 吳國豪. 腸道屏障功能 [J]. 腸外與腸內(nèi)營養(yǎng), 2004; 11(1)∶44.
- 8. 李志軍, 湯日波, 張萬祥. 腸道屏障功能損害與SIRS/MODS的發(fā)生及其防治 [J]. 中國危重病急救醫(yī)學, 2000; 12(12)∶766.
- 9. Demling RH. The clinical relevance of defining the mechanism for altered gut permeability in a “twohit”model of injury and infection [J]. Crit Care Med, 2004; 32(11)∶2356.
- 10. Choudhry MA, Rana SN, Kavanaugh MJ. Impaired intestinal immunity and barrier function: a cause for enhanced bacterial translocation in alcohol intoxication and burn injury [J]. Alcohol, 2004; 33(3)∶199.
- 11. 常建星.全身炎癥反應綜合征與腸屏障的損害 [J]. 國外醫(yī)學·外科學分冊, 2004; 31(3)∶158.
- 12. 張良成. 創(chuàng)傷和失血性休克后腸道屏障功能不全及其與MODS發(fā)生的關(guān)系 [J]. 國外醫(yī)學·麻醉學與復蘇分冊, 2001; 22(4)∶237.
- 13. Berg RD, Garlington AW. Transplantation of certain indigenous from the gastrointerstinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model [J]. Infect Immun, 1979; 23(2)∶403.
- 14. 石剛. 腸道黏膜屏障的損傷與保護 [J]. 腸外與腸內(nèi)營養(yǎng), 2004; 11(1)∶61.
- 15. DeSouza DA, Greene LJ. Intestinal permeability and systemic infections in critically ill patients: effect of glutamine [J]. Crit Care Med, 2005; 33(5)∶1125.
- 16. Ding LA, Li JS. Gut in diseases: physiological elements and their clinical significance [J]. World J Gastroenterol, 2003; 9(11)∶2385.
- 17. Steinberg SM. Bacterial translocation: what it is and what it is not.
- 18. Luyer MD, Buurman WA, Hadfoune M, et al. Strainspecific effects of probiotics on gut barrier integrity following hemorrhagic shock [J]. Infect Immun, 2005; 73(6)∶3686.
- 19. 鄭躍杰, 段恕誠. 微生態(tài)失衡與內(nèi)源性感染 [J]. 中國實用兒科雜志, 2003; 18(5)∶302.
- 20. Lichtman SM. Bacterial [correction of baterial] translocation in humans [J]. J Pediatr Gastroenterol Nutr, 2001; 33(1)∶1.
- 21. 趙光俠. 胃腸道細菌移位、 胃液菌群變化與全身炎癥反應綜合征 [J]. 小兒急救醫(yī)學, 2003; 10(3)∶184.
- 22. Stefanov CS, Boyadzhiev NP, Uchikov AP. Enteral nutrition in sepsis patients.
- 23. Kell MR, Barry BD, Redmond HP. Systemic inflammatory response syndrome: a new direction?.