肠道细菌移位的研究现状

目的 探讨肠道细菌移位研究的进展。方法 复习2000年至2005年6月关于肠道通透性的改变、肠道菌群失调和全身炎症反应综合征（SIRS）的文献。结果 随着对SIRS和MODS的深入研究，越来越多的证据显示，肠道不仅是MODs的靶器官，更是始动器官。只有保证了肠道黏膜屏障的完整性，才能有效的预防肠道细菌移位。去除原发病，保证肠道的血供和氧供是最基本的治疗方法。早期启动肠道、建立肠内营养以及选择性的肠道去污染也是有效的治疗手段。结论 随着对肠道细菌移位认识的深入，我们的治疗手段不断丰富，可以更有效预防肠道细菌移位的发生，并阻止向SIRS和MODS进一步发展。

Study about Bacterial Translocation

Objective There are two main functions of gastrointestinal tract,digestion and absorption,and barrier function.The latter has an important defensive effect,which keeps the body away from the invading and damaging of bacteria and endotoxin.It maintains the systemic homeostasis.Intestinal dysfunction would happen when body suffers from diseases or harmful stimulations.The more serious intestinal disorders would harm the intestinal protective mechanism,or intestinal barrier function,and bacterial/endotoxin translocation,of intestinal failure(IF) would ensue.This article provides a critical review of the evidence indicating that an increase in bacterial translocation is associated with sepsis,and even the multiple organ failure syndrome in critically ill patients.The in-transit microorganisms play an essential role in the homeostasis of local and systemic immunity.Methods All studies published from 2000 to June 2005 about intestinal permeability,bacterial translocation,and systemic inflammatory response syndrome were located by search of PubMed.Results Clinical and experimental studies investigating the correlation between bacterial translocation and systemic inflammatory response syndrome,associated with the damage of the gut barrier function.To keep the mucosal barrier function intact is one of the main issues in the prevention of bacterial translocation.This could be achieved by the adequate delivery of oxygen and nutrient supplementation to the gut.Enteral nutrition,probiotic can be a good choice.Conclusion With a better understanding of the bacteria-host interactions in health and the alterations induced by critical illness,new therapies that improve the environment of both may lead to better recovery rates in intensive care unit patients.