肠道微生态与肝病的关系

300170、。。。Ｒ575A1001－5256201504－0642－04AreviewofrelationshipbetweengutmicroecologyandliverdiseasesWANGXiaotongHANTao．TheThirdCentralClinicalCollegeofTianjinMedicalUniversityTianjin300170ChinaAbstractInrecentyearsgutmicroecologyhasattractedincreasingattentionbecauseofitscloserelationshipwiththedevelopmentandpro-gressionofvariousliverdiseasesandassociatedcomplications．Theimpairmentofliverfunctioncandisturbgutmicroecologywhereastheimbalanceingutmicroecologyinturnpromotestheaggravationofliverdiseases．Thispaperreviewstherelationshipbetweengutmicroecolo-gyandvariousliverdiseasesanddiscussestheroleofmodulatinggutmicroecologyinthetreatmentofliverdiseases．Anewideaisprovidedforthepreventionandtreatmentofliverdiseasesbasedonthemodulationofgutmicroecology．Keywordsliverdiseasesgutmicroecologyenterobacteriaceaebacterialtranslocationreviewdoi10．3969/j．issn．1001－5256．2015．04．0412014－08－122014－09－10。2012ZX10002004－01113ＲCGFSY192001989－。[e-mail]。、。、。。、、。。。。1、。。1。。2。。3。、、sIgA、。4。。ＲNA16SrＲNA。Zoetendal116SrＲNAdenaturinggra-dientgelelectrophoresisPCＲ－DGGE。Ley216SrＲNA500～1000、。Eckberg331335516SrＲNA。224631420154JClinHepatolVol．31No．4Apr．2015。。。2．1NAFLDNAFLD。Cani4。Miele5NAFLDsmallintestinalbacteriaovergrowthSIBO。2005Ley650%。Ley2。Henao－Mejia7NLＲP3NLＲP6。2．2ALDALD、。Yan8316SrＲNA。96TollToll－likereceptorTLＲ4TLＲ4。Mutlu1048。2．3CHBCHB、、、。CHB。、11。12。CHB。12B/E。2．413－15。spontaneousbacte-rialperitonitisSBP16。Lu17B/EB/EsIgA。Chen18。1929、、－、、6Child－Pugh。。。2．5HEHE、。minimalhepaticencephalopathyMHE。、、。SIBOMHESIBOSIBOSIBOSIBO1MHE、SIBOMHE20－21。MHE22。3、。3．1。23。5424。3．2、。HESBP。346．25。Flamm26、、HE6HE。Lauritano27SIBO1。Lutz28152SBPSBPSBP。Kimer29MetaHE。。3．3、。3、、30。Tian31、、。Malaguarnera323HE。Chen333。34+、、6α。Liu354+MHE、。、、。3．4fecalmicrobiotatransplantationFMTFMT。36。。Verieze376。、FMT。FMT、、。3．5N－3839。Chiva40C+CCl4、。4。、、、、。。1ZOETENDALEGAKKEＲMANSADLAKKEＲMANS－vanVLIETWM．ThehostgenotypeaffectsthebacterialcommunityinthehumangastrointestinaltractJ．MicrobEcolHealthDis2001133129－134．2LEYＲETUＲNBAUGHPJKLEINSetal．MicrobialecologyhumangutmicrobesassociatedwithobesityJ．Nature200644471221022－1023．3ECKBUＲGPBBIKEMBEＲNSTEINCNetal．DiversityofthehumanintestinalmicrobialfloraJ．Science200530857281635－1638．4CANIPDBIBILONIＲKNAUFCetal．Changesingutmicrobi-otacontrolmetabolicendotoxemia－inducedinflammationinhigh－fatdiet－inducedobesityanddiabetesinmiceJ．Diabetes20085761470－1481．5MIELELVALENZAVLATOＲＲEGetal．IncreasedintestinalpermeabilityandtightjunctionalterationsinnonalcoholicfattyliverdiseaseJ．Hepatology20094961877－1887．6LEYＲEBCKHEDFTUＲNBAUGHPetal．ObesityaltersgutmicrobialecologyJ．ProcNatlAcadSciUSA20051023111070－11075．7HENAO－MEJIAJELINAVEJINCetal．Inflammasome－mediateddysbiosisregulatesprogressionofNAFLDandobesityJ．Nature20124827384179－185．8YANAWFOUTSDEBＲANDLJetal．Entericdysbiosisassoci-atedwithamousemodelofalcoholicliverdiseaseJ．Hepatology201153196－105．9LIXWANGCNIEJetal．TLＲ4contributestointestinalhy-perpermeabilityinalcoholicliverdiseaseJ．ChinJHepatol2014223209－212．inChinese．Toll4J．2014223209－212．10MUTLUEAGILLEVETPMＲANGWALAHetal．Colonicmi-crobiomeisalteredinalcoholismJ．AmJPhysiolGastrointestLiverPhysiol20123029g966－g978．11LIUJQ．StudyonmolecularecologyofintestinalflorainpatientswithchronichepatitisBD．ShanghaiShanghaiJiaoTongUni-versity2011．inChinese44631420154JClinHepatolVol．31No．4Apr．2015．D．2011．12LILJWUZW．StudyonroleofintestinalmicroflorachangesinchronicliverdiseasesJ．ChinJMicroecology200214263－64．inChinese．J．200214263－64．13CHANGCSCHENGHLIENHCetal．Smallintestinedysmo-tilityandbacterialovergrowthincirrhoticpatientswithspontaneousbacterialperitonitisJ．Hepatology19982851187－1190．14XIEGZHONGWLIHetal．AlterationofbileacidmetabolismintheratinducedbychronicethanolconsumptionJ．FASEBJ20132793583－3593．15TELTSCHIKZWIESTＲBEISNEＲJetal．IntestinalbacterialtranslocationinratswithcirrhosisisrelatedtocompromisedPanethcellantimicrobialhostdefenseJ．Hepatology20125541154－1163．16GUAＲNEＲCSOＲIANOG．Bacterialtranslocationanditsconse-quencesinpatientswithcirrhosisJ．EurJGastroenterolHepatol200517127－31．17LUHWUZXUWetal．IntestinalmicrobiotawasassessedincirrhoticpatientswithhepatitisBvirusinfection．Intestinalmicrobi-otaofHBVcirrhoticpatientsJ．MicrobEcol2011613693－703．18CHENYYANGFLUHetal．Characterizationoffecalmicrobi-alcommunitiesinpatientswithlivercirrhosisJ．Hepatology2011542562－572．19WUXWUYFMAOCLetal．ChangesinintestinalmicroflorainpatientswithhepaticcirrhosisJ．WorldChinJDig201220262491－2495．inChinese．J．201220262491－2495．20CAOBFENGYKLIGQ．Ｒesearchonrelationshipbetweensmallintestinalbacterialovergrowthandminimalhepaticencepha-lopathyinpatientswithcirrhosisJ．IntJInterMed200835265－67．inChinese．J．200835265－67．21CAOBWANGYFENGYKetal．Theplasmaendotoxiclevelsinsmallintestinalbacteriaovergrowthcorrelatingminimalhepaticencepha-lopathyinpatientswithcirrhosisJ．ChinJGastroenterolHepatol2009187618－620．inChinese．J．2009187618－620．22TＲANAHTHVIJAYGKＲYANJMetal．Systemicinflamma-tionandammoniainhepaticencephalopathyJ．MetabBrainDis20132811－5．23ZHANGSCWANGWＲENWYetal．Effectofcisaprideonin-testinalbacterialandendotoxintranslocationinci