肠屏障功能损伤机制及其临床检测方法研究现状

尉浩斌; 张小丹; 李苏宜

doi:10.16689/j.cnki.cn11-9349/r.2020.04.006

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肿瘤代谢与营养电子杂志 ›› 2020, Vol. 7 ›› Issue (4) : 407-414. DOI: 10.16689/j.cnki.cn11-9349/r.2020.04.006

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肠屏障功能损伤机制及其临床检测方法研究现状

尉浩斌1，张小丹2，李苏宜2

作者信息 +

Research status of the mechanism of intestinal barrier function injury and its clinical detection methods

Yu Haobin1,Zhang Xiaodan 2, Li Suyi2

Author information +

文章历史 +

摘要

肠道作为机体的消化器官，除了具有消化吸收和蠕动功能外，还具有内分泌、免疫调节和黏膜屏障功能。生理状态下的肠屏障功能可消化和吸收营养物质、有效防止机体内环境受到有害物质的侵害，保障机体内环境稳定，由机械屏障、免疫屏障、化学屏障和生物屏障共同组成。肠屏障功能损伤机制复杂，临床上多种因素可直接或间接破坏肠屏障功能，这些因素包括严重感染、创伤、烧伤、肠梗阻、急性胰腺炎、重度营养不良、重度失血、失液、长期应用广谱抗生素或免疫抑制剂、电离辐射、放疗、化疗等。这些因素可从一个或多个方面造成肠屏障功能损伤，导致肠内病原微生物及其代谢物经门静脉和淋巴系统纵向易位入血，引发菌血症和毒血症，严重时可导致全身炎症反应综合征和多系统器官功能衰竭。目前检测多采用血液中D-乳酸的水平、二胺氧化酶、内毒素等来评估肠屏障功能。临床工作中应予重视肠屏障功能障碍的治疗。本文对肠道屏障及其损伤发生的机制，诊断和治疗方法进行综述。

Abstract

As the digestive organ of the body, the intestinal tract not only has the functions of digestion, absorption and peristalsis, but also has the functions of endocrine, immune regulation and mucosal barrier. The intestinal barrier function under physiological conditions can digest and absorb nutrients, effectively prevent the internal environment from being harmed by harmful substances, ensure the stability of internal environment, it consists of mechanical barrier, immune barrier, chemical barrier and biological barrier. The mechanism of intestinal barrier function damage is complex, and a variety of clinical factors can directly or indirectly damage intestinal barrier function, including severe infection, trauma, burn, intestinal obstruction, acute pancreatitis, severe malnutrition, severe blood loss, fluid loss, long-term application of broad-spectrum antibiotics or immunosuppressive agents, ionizing radiation, radiotherapy, chemotherapy, etc. These factors can lead to impaired intestinal barrier function in one or more ways, causing vertical translocation of intestinal pathogenic microorganisms and their metabolites into the blood through the portal vein and lymphatic system, causing bacteremia and toxaemia, and in severe cases, leading to systemic inflammatory response syndrome and multi-system organ failure. At present, the level of D-lactic acid, diamine oxidase and endotoxin in blood are mostly used to evaluate the intestinal barrier function. Attention should be paid to the treatment of intestinal barrier dysfunction in clinical work. In this paper, the mechanism, diagnosis and treatment of intestinal barrier and its injury are reviewed.

导出引用

尉浩斌，张小丹，李苏宜. 肠屏障功能损伤机制及其临床检测方法研究现状[J]. 肿瘤代谢与营养电子杂志. 2020, 7(4): 407-414 https://doi.org/10.16689/j.cnki.cn11-9349/r.2020.04.006

Yu Haobin,Zhang Xiaodan, Li Suyi. Research status of the mechanism of intestinal barrier function injury and its clinical detection methods[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2020, 7(4): 407-414 https://doi.org/10.16689/j.cnki.cn11-9349/r.2020.04.006

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