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中华卫生应急电子杂志 ›› 2023, Vol. 09 ›› Issue (05) : 315 -317. doi: 10.3877/cma.j.issn.2095-9133.2023.05.011

综述

严重烧伤早期肠道损伤防治研究进展
李洋洋1, 周彪2,(), 高仪轩3, 巴特2, 德奇4   
  1. 1. 014010 内蒙古包头,内蒙古医科大学第三临床医学院
    2. 014010 内蒙古包头,内蒙古包钢医院烧伤外科、内蒙古烧伤医学研究所
    3. 100142 北京,中国人民解放军空军特色医学中心
    4. 021000 呼伦贝尔市,呼伦贝尔市医院普外科
  • 收稿日期:2023-10-01 出版日期:2023-10-18
  • 通信作者: 周彪
  • 基金资助:
    重大疾病防治科技行动计划(2018-ZX-01S-001); 内蒙古自治区自然科学基金项目(2020MS08002); 内蒙古自治区自然科学基金项目(2020MS08181); 内蒙古自治区科技创新引导项目(CXYD2020BT03)

Research progress in the prevention and treatment of early intestinal injury in severe burns

Yangyang Li, Biao Zhou(), Yixuan Gao   

  • Received:2023-10-01 Published:2023-10-18
  • Corresponding author: Biao Zhou
引用本文:

李洋洋, 周彪, 高仪轩, 巴特, 德奇. 严重烧伤早期肠道损伤防治研究进展[J]. 中华卫生应急电子杂志, 2023, 09(05): 315-317.

Yangyang Li, Biao Zhou, Yixuan Gao. Research progress in the prevention and treatment of early intestinal injury in severe burns[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2023, 09(05): 315-317.

肠道屏障主要由黏液和上皮细胞组成[1],主要包括物理、化学、免疫和微生物屏障[2],是防止肠腔内有害物质进入血液循环,维持机体内部环境的相对稳定,及维持机体正常生命活动的功能性隔离带[3]。严重烧伤后,由于体液流失和肠道血流量减少,胃肠道系统缺血缺氧,导致肠道屏障作用减弱、免疫功能低下和肠道微生物紊乱,并且肠道通透性增加导致促炎信号传导,肠道屏障进一步受损。肠道屏障功能损伤后可导致炎症细胞浸润,炎性细胞因子产生,细菌过度生长,肠道上皮细胞屏障的破坏,形成恶性循环,最终导致全身炎症和器官损伤[4]。严重烧伤中已发生肠道屏障损伤患者的脓毒症、全身炎症反应综合征及多器官功能障碍综合征的发生风险是未发生肠道屏障损伤患者的数倍[5]。因此,肠道损伤对于严重烧伤引起的并发症具有重要作用,而预防严重烧伤患者的肠道损伤在烧伤救治中具有十分重要的意义。笔者针对严重烧伤早期肠道损伤的机制及防治进行综述,旨在为严重烧伤后肠道损伤的深入研究提供思路。

1
Chen YCui WLi X,et al.Interaction between commensal bacteria,immune response and the intestinal barrier in inflammatory bowel disease[J].Front Immunol2021(12):761981.
2
胡颖俊,陈思敏,闫文睿,等.肠道微生物群在糖尿病肾病防治中的研究进展[J].微生物学通报2023:1-13.
3
Che QLuo TShi J,et al.Mechanisms by which traditional Chinese medicines influence the intestinal flora and intestinal barrier[J].Front Cell Infect Microbiol2022(12):863779.
4
Luck MELi XHerrnreiter CJ,et al.IL-27 promotes intestinal barrier integrity following ethanol intoxication and burn injury[J].Immunohorizons20226(8):600-613.
5
Corcione SLupia TDe Rosa FG.Microbiome in the setting of burn patients: implications for infections and clinical outcomes[J].Burns Trauma2020(8):a33.
6
娄家祺,厉晔,崔庆伟,等.胰岛素强化治疗联合谷氨酰胺对严重烧伤患者营养代谢和炎症反应及血流动力学影响的前瞻性随机对照研究[J].中华烧伤杂志202137(9):821-830.
7
Wang HXi ZDeng L,et al.Macrophage polarization and liver ischemia-reperfusion injury[J].Int J Med Sci202118(5):1104-1113.
8
Liu XChen YYou B,et al.Molecular mechanism mediating enteric bacterial translocation after severe burn: the role of cystic fibrosis transmembrane conductance regulator[J].Burns Trauma2020(9):a42.
9
罗梦笛,何庆.心肺复苏后肠黏膜屏障功能受损机制的研究进展[J].心血管病学进展202243(3):241-244.
10
张雪敏,陈炯.烧伤休克期缺血再灌注损伤研究指标的进展[J].实用医学杂志201329(19):3110-3112.
11
卓明,叶军明,王万辉,等.缺血预/后处理对肠缺血再灌注损伤保护作用的研究进展[J].赣南医学院学报202141(6):633-638.
12
Gong ZYYuan ZQDong ZW,et al.Glutamine with probiotics attenuates intestinal inflammation and oxidative stress in a rat burn injury model through altered iNOS gene aberrant methylation[J].Am J Transl Res20179(5):2535-2547.
13
崔强,王洪瑾,李毅,等.富氢盐水对高原环境下烧伤小鼠肠道损伤的影响[J].中国现代应用药学202340(1):10-17.
14
Feng YHuang YWang Y,et al.Severe burn injury alters intestinal microbiota composition and impairs intestinal barrier in mice[J].Burns Trauma2019(7):20.
15
Xu PBecker HElizalde M,et al.Interleukin-28A induces epithelial barrier dysfunction in CD patient-derived intestinal organoids[J].Am J Physiol Gastrointest Liver Physiol2021320(5):G689-G699.
16
Graham WVHe WMarchiando AM,et al.Intracellular MLCK1 diversion reverses barrier loss to restore mucosal homeostasis[J].Nat Med201925(4):690-700.
17
温海玲,杨景哲,孟祥熙,等.马钱苷对严重烧伤大鼠肠道屏障的保护作用机制研究[J].川北医学院学报202338(3):299-302.
18
吴丹,王超,李腾,等.重组人肠三叶因子对烧伤小鼠肠黏膜损伤与修复的影响及机制研究[J].中华烧伤杂志202137(9):10.
19
Morris NLCannon ARLi X,et al.Protective effects of PX478 on gut barrier in a mouse model of ethanol and burn injury[J].J Leukoc Biol2021109(6):1121-1130.
20
刘胜利,彭晓菁,郑健生.烧伤后肠道菌群变化的研究进展[J].东南国防医药202224(2):176-180.
21
吴丹,苏森,魏燕,等.肠黏液屏障与烧伤后肠道损伤修复的研究进展[J].中华烧伤与创面修复杂志202238(8):788-793.
22
李嵩,张森林.早期肠内营养治疗大面积重度烧伤患者疗效分析[J].中国烧伤创疡杂志202133(6):395-398.
23
Pham CHFang MVrouwe SQ,et al.Evaluating the safety and efficacy of intraoperative enteral nutrition in critically ill burn patients:a systematic review and meta-analysis[J].J Burn Care Res202041(4):841-848.
24
Kurmis RNicholls CSinger Y,et al.An investigation of early enteral nutrition provision in major burn patients in australia and new zealand[J].Nutr Diet202279(5):582-589.
25
付娟,谢卫国,褚志刚,等.重症烧伤病人的营养治疗及临床指标分析[J].肠外与肠内营养202229(6):351-357.
26
吴宇文,刘军,金钧,等.严重烧伤患者早期肠内营养的治疗效果[J].中华烧伤杂志201834(1):40-46.
27
罗月,黎宁.严重烧伤患者早期肠内营养治疗的研究进展[J].中华烧伤杂志202137(9):880-884.
28
Yang YSu SZhang Y,et al.Effects of different ratios of carbohydrate-fat in enteral nutrition on metabolic pattern and organ damage in burned rats[J].Nutrients202214(17):3653.
29
彭曦.我国烧伤营养的发展历程与未来方向[J/CD].中华损伤与修复杂志(电子版), 202015(5):331-336.
30
Li PZhong CQiao S,et al.Effect of supplemental parenteral nutrition on all-cause mortality in critically ill adults:a meta-analysis and subgroup analysis[J].Front Nutr2022(9):897846.
31
韩春茂,张莉萍,吴攀.从理论到实践浅论严重烧伤患者的精准营养支持[J].中华烧伤与创面修复杂志202238(8):701-706.
32
Xie WHuang XChen R,et al.Esomeprazole alleviates the damage to stress ulcer in rats through not only its antisecretory effect but its antioxidant effect by inactivating the p38 MAPK and NF-κB signaling pathways[J].Drug Des Devel Ther2019(13):2969-2984.
33
Zhou BTe BWang L,et al.Combination of sodium butyrate and probiotics ameliorates severe burn-induced intestinal injury by inhibiting oxidative stress and inflammatory response[J].Burns202248(5):1213-1220.
34
Khare VKrnjic AFrick A,et al.Mesalamine and azathioprine modulate junctional complexes and restore epithelial barrier function in intestinal inflammation[J].Sci Rep20199(1):2842.
35
韩思琪,哈伟,师彦平.大黄及其有效成分抗炎作用的研究进展[J].中草药202354(01):303-316.
36
DiGuilio KMRybakovsky EAbdavies R,et al.Micronutrient improvement of epithelial barrier function in various disease states:a case for adjuvant therapy[J].Int J Mol Sci202223(6):2995.
37
张庆红,姚咏明.我国烧伤感染与免疫研究回顾和展望[J/CD].中华损伤与修复杂志(电子版), 201914(5):325-329.
38
Wen ZLZhang LDLiu SZ,et al.Effect of broad-spectrum antibiotics on bacterial translocation in burned or septic rats[J].Chin Med J (Engl)2019132(10):1179-1187.
39
Feng YHuang YWang Y,et al.Antibiotics induced intestinal tight junction barrier dysfunction is associated with microbiota dysbiosis,activated NLRP3 inflammasome and autophagy[J].PLoS One201914(6):e218384.
40
吕广平,陶白江,曾丁,等.特大面积烧伤后期顽固性残余创面的治疗体会[J/CD].中华损伤与修复杂志(电子版)201914(4):297-299.
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