|本期目录/Table of Contents|

[1]刘胜利,彭晓菁,郑健生.烧伤后肠道菌群变化的研究进展[J].医学研究与战创伤救治(原医学研究生学报),2022,24(2):176-180.[doi:10.3969/j.issn.1672-271X.2022.02.014]
 LIU Sheng-li,PENG Xiao-jing,ZHENG Jian-sheng.Research progress on changes of intestinal flora after burn[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(2):176-180.[doi:10.3969/j.issn.1672-271X.2022.02.014]
点击复制

烧伤后肠道菌群变化的研究进展()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年2期
页码:
176-180
栏目:
综述
出版日期:
2022-03-20

文章信息/Info

Title:
Research progress on changes of intestinal flora after burn
作者:
刘胜利彭晓菁郑健生
作者单位:363000漳州,联勤保障部队第九○九医院(厦门大学附属东南医院)烧伤整形科(刘胜利、彭晓菁、郑健生)
Author(s):
LIU Sheng-li PENG Xiao-jing ZHENG Jian-sheng
(Department of Burns and Plastic Surgery, the Affiliated Dongnan Hospital of Xiamen University, School of Medicine,Xiamen University, Zhangzhou 363000, Fujian, China)
关键词:
烧伤肠道菌群全身多器官功能障碍治疗
Keywords:
burn intestinal flora systemic multiple organ dysfunction treatment
分类号:
R644
DOI:
10.3969/j.issn.1672-271X.2022.02.014
文献标志码:
A
摘要:
烧伤是人体外伤最常见的原因之一,因体液失衡,疼痛重,易感染,病程长等原因,治疗过程中会出现多系统的并发症。烧伤后强烈的应急反应对消化系统影响较大。Curling溃疡在临床工作中经常被提及。除此以外,消化道的病症又影响着烧伤的整个治疗过程,如肠内营养支持,内源性感染等。除人体消化道器官病生变化外,消化道内的菌群也发挥了至关重要的作用。甚至将包括肠道菌群在内的消化系统被认为是人体的“第二神经中枢”。烧伤后肠道内有益菌的减少,有害菌的增加已被广泛认知,很早临床医师便指出可针对性应用益生菌,且取得了很好的效果,使患者受益。随着目前广泛而深入的研究,肠道菌群的秘密被逐步揭开。文章主要综述烧伤后肠道菌群变化的研究进展,从不同角度分析引发烧伤后肠道菌群失调的关键影响因素以及烧伤后肠道菌群失调对全身多系统,多器官可能带来的损伤,搜集整理了烧伤后肠道菌群失调的防治方法。提出烧伤后通过早期肠道营养,补充益生菌,消化道去污等综合性预防与治疗,可改善严重烧伤患者预后。肠道菌群的研究可能成为逆转烧伤多器官功能障碍的新靶向。
Abstract:
Burning is one of the most common causes of human trauma. Due to fluid imbalance, heavy pain, easy infection and long course of disease, there will be multi system complications in the treatment process. The strong emergency response after burning has a great impact on the digestive system. Curling ulcer is often mentioned in clinical work. In addition, gastrointestinal diseases affect the entire treatment process of burns, such as enteral nutrition support, endogenous infection and so on. In addition to the pathological changes of human digestive tract organs, the flora in the digestive tract also plays a vital role. Even the digestive system, including intestinal flora, is regarded as the "second nerve center" of the human body. The decrease of beneficial bacteria and the increase of harmful bacteria in the intestinal tract after burn have been broadly recognized. Clinicians pointed out that probiotics can be applied targeted for a long time, and achieved good results, benefiting patients. With the extensive and in-depth research, the secret of intestinal flora has been gradually revealed. Therefore, we searched the current relevant literature, reviewed the research progress of intestinal flora changes after burn, analyzed the key influencing factors of intestinal flora imbalance after burn from different angles, and the possible damage of intestinal flora imbalance after burn to multiple systems and organs of the whole body, and collected and sorted out the prevention and treatment methods of intestinal flora imbalance after burn. In addition, it is proposed that the prognosis of severe burn patients can be improved through comprehensive prevention and treatment such as primary intestinal nutrition, probiotics supplementation and gastrointestinal decontamination. We believe that the study of intestinal flora may become a new target to reverse burn multiple organ dysfunction.

参考文献/References:

[1]Su C, Liu Y, Zhang H, et al. Investigation of the Effects of Antibiotic Application on the Intestinal Flora in Elderly Hypertension Patients with Infectious Diseases[J].Iran J Public Health, 2018, 47(3):335.
[2]Gnauck A, Lentle RG, Kruger MC. The characteristics and function of bacterial lipopolysaccharides and their endotoxic potential in humans[J]. Int Rev Immunol, 2015:189-218.
[3]Guangtao H, Kedai S, Supeng Y, et al. Burn Injury Leads to Increase in Relative Abundance of Opportunistic Pathogens in the Rat Gastrointestinal Microbiome[J]. Front Microbiol, 2017,8:1237.
[4]Hidalgo F, Mas D, Rubio M, et al. Infections in critically ill burn patients[J]. Med Intensiva, 2016, 40(3):179-185.
[5]肖光夏. 肠源性感染的研究[J]. 中华烧伤杂志, 2008, 24(5):4.
[6]Earley ZM, Suhail A, Green SJ, et al. Burn Injury Alters the Intestinal Microbiome and Increases Gut Permeability and Bacterial Translocation[J]. PLoS One, 2015, 10(7):e0129996.
[7]Shimizu K, Ogura H, Asahara T, et al. Gut microbiota and environment in patients with major burns-A preliminary report[J]. Burns, 2015,41(3):.e28-e33.
[8]Beckmann N, Pugh AM, Caldwell CC, et al. Burn injury alters the intestinal microbiome’s taxonomic composition and functional gene expression[J]. PLoS One, 2018,13(10):e0205307.
[9]Zhang D, Li YT, Ding LL, et al. Prevalence and outcome of acute gastrointestinal injury in critically ill patients: A systematic review and meta-analysis[J]. Medicine (Baltimore), 2018,97(43):e12970.
[10]Fay KT, Ford ML, Coopersmith CM. The intestinal microenvironment in sepsis[J]. BBA-Mol Basis Dis, 2017,1863(10 Pt B):2574-2583.
[11]Abt MC, Artis D. The intestinal microbiota in health and disease: the influence of microbial products on immune cell homeostasis[J]. Curr Opin Gastroenterol, 2009, 25(6):496-502.
[12]Babrowski T, Romanowski K, Fink D, et al. The intestinal environment of surgical injury transforms Pseudomonas aeruginosa into a discrete hypervirulent morphotype capable of causing lethal peritonitis[J]. Surgery, 2013, 153(1):36-43.
[13]王颖, 奚海燕, 李玲慧,等. 肠道细菌移位与血流感染[J]. 东南国防医药, 2014, 16(5):514-516.
[14]张发明. 菌群重建治疗菌群失调相关性疾病的再认识[J]. 医学研究生学报, 2019, 32(12):1233-1236.
[15]张哲瑞, 陈凤容. 粪菌移植在临床应用中的研究进展[J]. 医学研究生学报, 2020, 33(4):428-432.
[16]Dabke K, Hendrick G, Devkota S. The gut microbiome and metabolic syndrome[J]. J Clin Invest, 2019, 129(10):4050-4057.
[17]Tanase DM, Gosav EM, Neculae E, et al. Role of Gut Microbiota on Onset and Progression of Microvascular Complications of Type 2 Diabetes (T2DM)[J]. Nutrients, 2020, 12(12):3719.
[18]Kim MH, Yun KE, Kim J, et al. Gut microbiota and metabolic health among overweight and obese individuals[J]. Sci Rep, 2020, 10(1):19417.
[19]Mazidi M, Rezaie P, Kengne AP, et al. Gut microbiome and metabolic syndrome.[J]. Diabetes Metab Synd, 2016:S150-S157.
[20]Xiong Y, Xiong Y, Zhu P, et al. The Role of Gut Microbiota in Hypertension Pathogenesis and the Efficacy of Antihypertensive Drugs[J]. Curr Hypertens Rep, 2021, 23(8):1-14.
[21]Rooks MG, Garrett WS. Gut microbiota, metabolites and host immunity[J]. Nat Rev Immunol, 2016, 16(6):341.
[22]Ohno H. The impact of metabolites derived from the gut microbiota on immune regulation and diseases[J]. Int Immunol,2020,32(10):629-636.
[23]Ganal-Vonarburg SC, Duerr CU. The interaction of intestinal microbiota and innate lymphoid cells in health and disease throughout life[J]. Immunology, 2020,159(1):39-51.
[24]Straar M, Temba GS, Vlamakis H, et al. Author Correction: Gut microbiome-mediated metabolism effects on immunity in rural and urban African populations [J]. Nat Commun, 2021,12(1):5818.
[25]Brown EM, Kenny DJ, Xavier RJ. Gut Microbiota Regulation of T Cells During Inflammation and Autoimmunity[J]. Annu Rev Immunol, 2019, 37(1):599-624.
[26]Meng M, Klingensmith NJ, Coopersmith CM. New insights into the gut as the driver of critical illness and organ failure[J]. Curr Opin Crit Care, 2017, 23(2):143-148.
[27]Tran SM, Mohajeri MH. The Role of Gut Bacterial Metabolites in Brain Development, Aging and Disease[J]. Nutrients, 2021,13(3):732.
[28]Fang X. Microbial treatment: the potential application for Parkinson’s disease[J]. Neurol Sci, 2019,40(1):51-58.
[29]Kennedy PJ, Cryan JF, Dinan TG, et al. Kynurenine pathway metabolism and the microbiota-gut-brain axis[J]. Neuropharmacology, 2017,112(Pt B):399-412.
[30]刘荣强,张天娥,王艳秋,等. 肠道菌群与阿尔茨海默病的研究进展[J].中国微生态学杂志,2019(1):112-115.
[31]Zhang Y, Geng R, Tu Q. Gut microbial involvement in Alzheimer’s disease pathogenesis[J]. Albany Ny, 2021,13(9):13359-13371.
[32]Cevasco M, Hastie J, Takayama H, et al. Expanding our arsenal against an old foe[J]. J Thorac Cardiov Sur, 2018,156(2):694-695.
[33]Vaziri ND, Zhao YY, Pahl MV. Altered intestinal microbial flora and impaired epithelial barrier structure and function in CKD: the nature, mechanisms, consequences and potential treatment[J]. Nephrol Dial Transplant, 2016,31(5):737-746.
[34]Huang X, Fan X, Ying J, et al. Emerging trends and research foci in gastrointestinal microbiome[J]. J Transl Med, 2019,17(1):67.
[35]Wang X, Yang J, Tian F, et al. Gut microbiota trajectory in patients with severe burn: A time series study[J]. J Crit Care, 2017,42:310-316.
[36]Wang ZE, Dan W, Zheng LW, et al. Effects of glutamine on intestinal mucus barrier after burn injury[J]. Am J Transl Res, 2018,10(11):3833-3846.
[37]Ps A, Arbb C, Mmb D, et al. ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr, 2019, 38(1):48-79.
[38]Salinas E, Reyes-Pavón D, Cortes-Perez NG, et al. Bioactive Compounds in Food as a Current Therapeutic Approach to Maintain a Healthy Intestinal Epithelium[J]. Microorganisms, 2021, 9(8):1634.
[39]Singh R, Sharma PK, Malviya R. Prebiotics: future trends in health care[J]. Mediterr J Nutr Meta, 2011, 5(2):81-90.
[40]Mayes T, Gottschlich MM, James LE, et al. Clinical Safety and Efficacy of Probiotic Administration Following Burn Injury[J]. J Burn Care Res, 2015,36(1):92-99.
[41]Wilkins T, Sequoia J. Probiotics for Gastrointestinal Conditions: A Summary of the Evidence[J]. Am Fam Physician, 2017,96(3):170-178.
[42]Venu L, Misharin AV, Liu NQ, et al. Vitamin D Deficiency in Mice Impairs Colonic Antibacterial Activity and Predisposes to Colitis[J]. Endocrinology, 2010,151(6):2423-2432.
[43]Heitmann BL. Prenatal and Early Life Exposure to the Danish Mandatory Vitamin D Fortification Policy Might Prevent Inflammatory Bowel Disease Later in Life: A Societal Experiment[J]. Nutrients, 2021,13(4):1367.
[44]Zhou X, Chen C, Zhong YN, et al. Effect and mechanism of vitamin D on the development of colorectal cancer based on intestinal flora disorder[J].J Gastroenterol Hepatol, 2020,35(6):1023-1031.
[45]Zhao H, Hong Z, Hui W, et al. Protective role of 1,25(OH)2vitamin D3 in the mucosal injury and epithelial barrier disruption in DSS-induced acute colitis in mice[J]. Bmc Gastroenterol, 2012, 12(1):57.
[46]Eslamian G, Ardehali SH, Hajimohammadebrahim-Ketabforoush M, et al. Association of intestinal permeability with admission vitamin D deficiency in patients who are critically ill[J]. J Invest Med, 2019, 68(2):jim-2019-001132.
[47]Xiao L, Cui T, Liu S, et al. Vitamin A supplementation improves the intestinal mucosal barrier and facilitates the expression of tight junction proteins in rats with diarrhea[J]. Nutrition, 2018, 57: 97-108.
[48]Wen ZL, Zhang LD, Liu SZ, et al. Effect of broad-spectrum antibiotics on bacterial translocation in burned or septic rats[J]. Chin Med J (Engl), 2019,132(10):1179-1187.
[49]Nood EV, Vrieze A, Nieuwdorp M, et al. Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile[J]. N Engl J Med, 2013, 368(5):407-415.
[50]Kuethe JW, Armocida SM, Midura EF, et al. Fecal Microbiota Transplant Restores Mucosal Integrity in a Murine Model of Burn Injury[J]. Shock, 2016, 45(6):647-652.
[51]Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections[J].Am J Gastroenterol, 2013, 108(4):478-498.
[52]Yao YM, Yu Y, Sheng ZY, et al. Role of gut-derived endotoxaemia and bacterial translocation in rats after thermal injury: effects of selective decontamination of the digestive tract[J]. Burns, 1995, 21(8):580-585.

相似文献/References:

[1]王 培,管云枫,徐添颖,等.G-CSF对大鼠烧伤合并海水浸泡后内皮祖细胞的影响[J].医学研究与战创伤救治(原医学研究生学报),2013,15(01):1.
 WANG Pei,GUAN Yun-feng,XU Tian-ying,et al.Effects of granulocyte colony-stimulating factor on the number of circulating endothelial progenitor cells in burned rats with seawater immersion[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2013,15(2):1.
[2]宗 林,倪洋林,王玉秀,等.光棒及纤维支气管镜在头面部烧伤插管中的应用[J].医学研究与战创伤救治(原医学研究生学报),2011,13(05):393.
 ZONG Lin,NI Yang-lin,WANG Yu-xiu,et al.Application of lightwand and fiberoptic bronchoscope on craniofacial burned patients with anticipated difficult airway[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(2):393.
[3]王媛,谢玮娜,于美华,等.全程保温对特重度大面积烧伤切痂植皮术患者体温的影响[J].医学研究与战创伤救治(原医学研究生学报),2010,12(05):450.
[4]张育淑,孔悦.深度手烧伤早期功能恢复的护理[J].医学研究与战创伤救治(原医学研究生学报),2010,12(06):550.
[5]朱剑仙,宋 斌,詹新华,等.应用保护性机械通气救治烧伤复合肺爆震伤[J].医学研究与战创伤救治(原医学研究生学报),2010,12(01):42.
 ZHU Jian-xian,SONG Bin,ZHAN Xin-hua,et al.Application of protective ventilation in the treatment of the burned patients with burst injury of the lungs[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2010,12(2):42.
[6]孙曙光,王良喜,孙建忠,等.烧冲复合伤中内脏损伤的临床特征和救治特点[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):145.
[7]卢承志,姚猛飞,陈敬文,等.23例特重度烧伤患者大面积切痂植皮的麻醉处理[J].医学研究与战创伤救治(原医学研究生学报),2009,11(04):312.
[8]朱剑仙,宋斌,詹新华,等.重度烧伤复合肺爆震伤临床救治的探讨[J].医学研究与战创伤救治(原医学研究生学报),2009,11(05):420.
 ZHU Jian-xian,SONG Bin,ZHAN Xin-hua,et al.Clinical study and treatment of severe burns combined with blast injury of the lungs[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(2):420.
[9]蔡少甫,郑庆亦,郭毅斌,等.严重烧伤患者血脂变化与感染关系的研究[J].医学研究与战创伤救治(原医学研究生学报),2008,10(04):274.
 CAI Shao-fu,ZHENG Qing-yi,GUO Yi-bin,et al.The study of serum lipids changes in patients with severe burns and its relations with infectious complications[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2008,10(2):274.
[10]曹淑琴,魏聿萍,曹丽丽,等.严重烧伤死亡原因分析与护理启示[J].医学研究与战创伤救治(原医学研究生学报),2008,10(04):295.

备注/Memo

备注/Memo:
基金项目:福建省自然科学基金(2019J01143);厦门大学附属东南医院2018年青年苗圃基金(18Y023)
更新日期/Last Update: 2022-04-18