肠道微生态在克罗恩病发病中的作用以及治疗前景

楼俪泓　曾　悦　王兴鹏*

上海交通大学附属第一人民医院国际医疗保健中心1(200080)　消化科2



肠道微生态在克罗恩病发病中的作用以及治疗前景

楼俪泓1曾悦2王兴鹏2*

上海交通大学附属第一人民医院国际医疗保健中心1(200080)消化科2

摘要克罗恩病(CD)的致病因素和发病机制至今尚未完全阐明，目前普遍认为其由遗传因素、免疫功能紊乱、肠道屏障功能障碍和肠道微生态改变等多因素所致。肠道微生态与CD发病的关系日益受到关注。多项证据表明CD患者存在肠道微生态改变，肠道微生态改变与CD发生相关，调节肠道微生态对CD有治疗作用。本文就肠道微生态与CD发病的关系以及治疗前景作一综述。

关键词肠道微生态；肠道菌群；炎症性肠病；Crohn病；治疗

Role and Therapeutic Prospect of Intestinal Microecology in Crohn’s Disease

LOULihong1,ZENGYue2,WANGXingpeng2.1InternationalMedicalCareCenter,2DepartmentofGastroenterology,ShanghaiGeneralHospital,ShanghaiJiaoTongUniversity,Shanghai(200080)

Correspondence to: WANG Xingpeng, Email: richardwangxp@163.com

AbstractThe etiology and pathogenesis of Crohn’s disease (CD) are not fully clear, and genetic susceptibility, immunologic disorder, intestinal barrier dysfunction and intestinal microecology are considered to be involved in the pathogenic mechanism of CD. In recent years, the relationship between intestinal microecology and CD has received much attention. Several studies confirmed that the intestinal microecology in CD patients was different from that in normal person. The change of intestinal microecology was correlated with the occurrence of CD, and modulation of intestinal flora was effective in the treatment of CD. This article reviewed the relationship between intestinal microecology and CD and the therapeutic prospect of intestinal microecology for the treatment of CD.

Key wordsIntestinal Microecology;Intestinal Bacterial Flora;Inflammatory Bowel Disease;Crohn Disease;Therapy

炎症性肠病(inflammatory bowel disease, IBD)是一种慢性消化道炎症性疾病，主要包括溃疡性结肠炎(ulcerative colitis, UC)和克罗恩病(Crohn’s disease, CD)。IBD的病因和发病机制尚未明确，目前普遍认为其由遗传因素、免疫功能紊乱、肠道屏障功能障碍和肠道微生态改变等多因素所致[1]。肠道微生态研究肠道正常微生物群的结构、功能及其与宿主相互依赖和相互制约的关系，目前肠道微生态与IBD尤其是CD的关系日益受到重视。疾病时肠道微生态与宿主之间的平衡关系被打破，恢复肠道微生态的稳定可能成为治疗CD的重要方向之一。本文就肠道微生态在CD发病中的作用以及治疗前景作一综述。

一、肠道微生态的构成、功能和影响因素

肠道微生态由肠道菌群、肠黏膜上皮和肠黏膜免疫系统等组成，其中肠道菌群发挥最重要的作用，而肠黏膜上皮间的紧密连接、上皮细胞分泌的黏液以及肠黏膜免疫系统协同构成肠道黏膜屏障。……