妊娠期肝内胆汁淤积症患者的肠道菌群变化及微生物疗法的研究进展

妊娠期肝内胆汁淤积症（ICP）是一种多发于妊娠晚期的疾病，严重影响着母婴结局，其病因和发病机制目前尚不清楚。血清胆汁酸水平是ICP诊断的主要临床依据，肠道菌群在胆汁酸的合成和代谢中起关键作用，肠道菌群及其代谢产物与ICP密切相关。微生物疗法如益生菌的使用可改善肠道微生物群，可作为治疗ICP的新思路。本文就ICP患者胆汁酸变化与肠道菌群之间的关系进行综述，分析肠道菌群与ICP发生发展的关系，发现某些特定菌种（如大肠杆菌志贺菌属、拟杆菌、双歧杆菌以及乳酸杆菌等）与ICP的发展密切相关，并总结益生菌改善胆汁淤积的研究进展，以期为ICP的临床治疗和管理提供新思路。

Changes of Intestinal Flora in Patients with Intrahepatic Cholestasis of Pregnancy and Progress of Microbial Therapy

Intrahepatic cholestasis of pregnancy (ICP) frequently manifests in late pregnancy, significantly impacts the well-being of both mothers and infants. Its etiology and pathogenesis remain unclear. The diagnosis of ICP primarily relies on serum bile acid levels. Intestinal flora significantly contributes to the synthesis and metabolism of bile acids, and both intestinal flora and its metabolites are closely associated with ICP. Microbiological interventions, including probiotic usage, can enhance the intestinal flora, presenting a novel approach for ICP treatment. In this paper, we reviewed the association between bile acid alterations and intestinal flora in ICP patients, analyzed the correlation between intestinal flora and ICP development, and found that specific bacterial strains (e.g., Escherichia/Shigella, Bacteroides, Bifidobacterium and Lactobacillus) closely linked to ICP development. Additionally, we summarized the advancements in research on probiotic utilization to ameliorate the cholestatic process, aming to enhance comprehension of ICP and offer fresh perspectives for its clinical treatment and management.