2025 年第 2 期 第 20 卷

肠道微生态调节在肝硬化并发感染防治中作用的研究进展

Research progress of the role of intestinal microecological regulation in the prevention and treatment of liver cirrhosis complicated with infection

作者：孙虹佳1毛小荣2

英文作者：Sun Hongjia1 Mao Xiaorong2

单位：1兰州大学第一医院医学检验中心兰州大学第一临床医学院，兰州730000；2兰州大学第一医院感染科兰州大学第一临床医学院，兰州730000

英文单位：1Medical Laboratory Center the First Hospital of Lanzhou University the First School of Clinical Medicine Lanzhou 730000 China; 2Department of Infectious Diseases the First Hospital of Lanzhou University the First School of Clinical Medicine Lanzhou 730000 China

关键词：肝硬化；感染；肠道微生态；肠道菌群

英文关键词：Livercirrhosis;Infection;Intestinalmicroecology;Gutmicrobiota

• 摘要：

• 感染会导致肝硬化的不良进展，病死率增高，而肝硬化向终末期发展又会加大患者感染的易感性，由此形成恶性循环。肝硬化患者免疫功能受损，肠屏障功能障碍，肠道菌群组成与功能改变，菌群移位，易并发感染。抗菌药物是抗感染最常用的手段，但传统经验性抗菌药物治疗或不合理的抗菌药物应用可能促进多重耐药菌的传播，同时也可能破坏肠道微生态，进一步加重感染的易感性。因此，新的预防和治疗肝硬化并发感染的方法需要被关注。本文旨在探讨肝硬化并发感染与肠道微生态的关系，并着重介绍肠道微生态调节，如益生菌、益生元、新型抗菌药物、肠道代谢物、粪菌移植及中医药调节在肝硬化并发感染中的应用，以期为肝硬化并发感染的防治提供新思路。

• Infection can lead to the adverse progression of liver cirrhosis and increase the mortality rate, while the development of liver cirrhosis to the end stage will increase the susceptibility of patients to infection, thus forming a vicious circle. Patients with liver cirrhosis have impaired immune function, intestinal barrier dysfunction, changes in the composition and function of intestinal flora, bacterial translocation, and are prone to infection. Antibiotics are the most commonly used means of anti-infection, but traditional empirical antibiotic therapy or irrational antibiotic use may promote the spread of multi-drug resistant bacteria, destroy intestinal microecology, and further increase the susceptibility to infection. Therefore, new methods for the prevention and treatment of liver cirrhosis complicated with infection need to be paid attention. This article aims to explore the relationship between liver cirrhosis complicated with infection and intestinal microecology, and focuses on the application of intestinal microecology regulation, such as probiotics, prebiotics, new antibiotics, intestinal metabolites, fecal microbiota transplantation and traditional Chinese medicine regulation in liver cirrhosis complicated with infection, in order to provide new ideas for the prevention and treatment of liver cirrhosis complicated with infection.