肠道菌群在慢性肝病和肝细胞癌中的作用及临床意义

肠道菌群是人体消化道内复杂、动态的微生态系统，生理条件下与宿主之间存在着平衡的共生关系。然而，在慢性肝病和肝癌等病理状态下，肠道菌群的组成和肠道通透性会发生显著变化，导致菌群失调和细菌易位。肠道细菌及其代谢产物一方面进入肝脏激活炎症相关信号通路，另一方面进入循环形成内毒素血症，共同促使慢性肝病和肝癌恶化进展。目前，针对肠道菌群治疗慢性肝病和肝癌的策略包括合理运用抗生素、益生菌或益生元，粪便微生物移植。本文就肠道菌群在慢性肝病和肝癌中的潜在作用及临床意义作一综述。

Role and clinical significance of gut microbiota in chronic liver diseases and hepatocellular carcinoma

The gut microbiota is a complex and dynamic micro-ecosystem in human intestinal tract, which has a balanced symbiotic relationship with the host under physiological conditions. However, in pathological conditions such as chronic liver diseases and hepatocellular carcinoma, the composition of gut microbiota and intestinal permeability will significantly change, leading to dysbiosis and bacterial translocation. Intestinal bacteria and their metabolites enter the liver to activate the inflammation associated signalling pathway, and flow into the systemic circulation to form endotoxemia, which jointly promote the progression of chronic liver diseases and hepatocellular carcinoma. Currently, therapeutic strategies aiming at gut microbiota for the treatment of chronic liver diseases and hepatocellular carcinoma include rational administration of antibiotics, probiotics or prebiotics, and fecal microbiota transplantation. This paper reviews the potential role and clinical significance of gut microbiota in chronic liver diseases and hepatocellular carcinoma.