摘要
肝脏与肠道能够通过肠肝轴进行双向影响.正常人体的肠道屏障可以限制肠源性细菌及大分子抗原和内毒素的滤过.对于接受肝移植的受者而言,供肝缺血再灌注损伤以及移植肝早期功能不全,将削弱胆汁酸对肠道菌群的抑制能力.肠道淤血导致炎症因子聚集,产生大量氧自由基,破坏肠道屏障并促使肠道菌群经肠肝轴移位.肠道微生态失衡会对供肝产生多方面影响,并增加肝移植围手术期感染、急性排斥反应和胆道并发症的发生风险.通过进一步探索肠道微生态影响肝移植围手术期并发症的新机制,及时发现并干预并发症的发生发展,将有效降低肝移植受者围手术期病死率,改善长期预后.
Abstract
The liver and gut can have bidirectional effects through the gut-liver axis.The gut barrier in a normal human can limit the filtration of gut bacteria,macromolecular antigens,and endotoxins.However,for liver transplantation recipients,ischemia-reperfusion injury and early functional impairment of the donor liver will weaken the inhibition of bile acids on gut microbiota.Gut congestion can cause the accumulation of inflammatory factors,produce a large amount of oxygen free radicals,disrupt the gut barrier,and promote the translocation of gut microbiota through the gut liver axis.The imbalance of gut microbiota can have multiple impacts on the donor liver and increase the risk of perioperative infection,acute rejection,and biliary complications.In the future,by further exploring the new mechanisms of the impact of gut microbiota on perioperative complications of liver transplantation,detection and intervention of the occurrence and development of complications,we will effectively reduce the perioperative mortality rate of patients,improve long-term prognosis,and bring positive effects to the development of liver transplantation.
基金项目
济南微生态生物医学省实验室(JNL-2022015B)
NETL
NSTL
万方数据