Acharya Chathur, Bajaj Jasmohan S
Division of General Internal Medicine, Virginia Commonwealth University, 1200 E Broad St, Richmond, VA 23298, USA.
Division of Gastroenterology, Hepatology, and Nutrition, McGuire VA Medical Center, Virginia Commonwealth University, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
Gastroenterol Clin North Am. 2017 Mar;46(1):155-169. doi: 10.1016/j.gtc.2016.09.013.
Chronic liver disease, cirrhosis, and its complications are epidemic worldwide. Most complications are mediated through a dysfunctional gut-liver axis. New techniques have made culture-independent analysis of the gut microbiome widespread. With insight into an unfavorable microbiome (dysbiosis) and how it affects liver disease, investigators have discovered new targets to potentially improve outcomes. Dysbiosis is associated with endotoxemia and propagates liver injury due to nonalcoholic steatohepatitis and alcohol. The composition and functionality of the microbiome changes with the development of cirrhosis, decompensation, and with treatments for these conditions. Gut microbiota can be used to predict clinically relevant outcomes in cirrhosis.
慢性肝病、肝硬化及其并发症在全球范围内流行。大多数并发症是通过功能失调的肠-肝轴介导的。新技术使对肠道微生物群的非培养分析广泛应用。随着对不良微生物群（生态失调）及其如何影响肝病的深入了解，研究人员发现了可能改善预后的新靶点。生态失调与内毒素血症有关，并因非酒精性脂肪性肝炎和酒精而加重肝损伤。微生物群的组成和功能随着肝硬化、失代偿的发展以及针对这些病症的治疗而发生变化。肠道微生物群可用于预测肝硬化的临床相关预后。
