肝硬化患者肠道菌群失调与肝性脑病的关系研究
肝硬化是临床常见的慢性进行性肝病，由一种或多种病因长期或反复作用引起弥漫性肝损害，其并发症肝性脑病严重影响患者生活质量及预后。本研究旨在探讨肝硬化患者肠道菌群失调与肝性脑病发生发展的关系。收集120例肝硬化患者（其中60例合并肝性脑病）及60例健康对照者的粪便样本，采用16S rRNA基因测序技术分析肠道菌群结构组成，并检测血氨等生化指标。结果显示，肝硬化组肠道菌群多样性降低，条件致病菌比例升高，有益菌减少，且肝性脑病组上述变化更为显著，血氨水平明显高于非肝性脑病组和健康对照组。进一步相关性分析发现，特定菌属丰度与血氨浓度、肝性脑病严重程度存在密切关联。
关键词：肝性脑病；肠道菌群失调；肝硬化
Abstract
Cirrhosis is a common chronic and progressive liver disease in clinical practice, with diffuse liver damage caused by long-term or repeated effects of one or more causes, and its complication hepatic encephalopathy seriously affects the quality of life and prognosis of patients. The aim of this study was to investigate the relationship between intestinal dysbiosis and the development of hepatic encephalopathy in patients with cirrhosis. Stool samples from 120 patients with cirrhosis (60 with hepatic encephalopathy) and 60 healthy controls were collected, and analyzed by 16S rRNA gene sequencing technology, and the biochemical indexes such as blood ammonia were detected. The results showed that the diversity of intestinal flora in the cirrhosis group decreased, the proportion of opportunistic pathogens increased, and the beneficial bacteria decreased, and the above changes were more significant in the hepatic encephalopathy group, and the blood ammonia level was significantly higher than that of the non-hepatic encephalopathy group and the healthy control group. Further correlation analysis found correlation bacterial abundance with blood ammonia concentration and severity of hepatic encephalopathy.
Key words: Hepatic encephalopathy; intestinal dysbiosis; liver cirrhosis
目 录
中文摘要 I
英文摘要 II
目 录 III
引 言 1
第1章、肠道菌群与肝硬化基础研究 2
1.1、肝硬化患者肠道菌群特征 2
1.2、菌群失调的病理机制 2
1.3、肠道屏障功能改变 2
第2章、肠道菌群失调对肝脏的影响 4
2.1、毒素产生与吸收增加 4
2.2、肝脏代谢负担加重 4
2.3、炎症反应与肝损伤 5
第3章、肠道菌群与肝性脑病关联 6
3.1、血氨水平变化分析 6
3.2、神经递质代谢紊乱 6
3.3、认知功能障碍机制 7
第4章、干预措施与临床应用 8
4.1、益生菌治疗效果评估 8
4.2、饮食调节方案探讨 8
4.3、未来研究方向展望 9
结 论 10
参考文献 11
