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目前,放疗是晚期肿瘤患者的主要治疗方式之一。由于肠道对射线具有高度敏感性,因此导致放射性肠炎(radiation enteritis, RE)的发生率居高不下。据报道,目前我国每年有3~5万人罹患RE,其主要表现为反复发作的恶心、呕吐、腹痛、腹泻、黏液脓血便甚至血便等,严重者甚至可并发肠梗阻、肠穿孔、肠瘘等[1-2]。随着对肠道菌群在疾病发生发展中的认识更加深刻,有关肠道菌群在RE中的作用机制成为了研究热点。我们总结了有关肠道菌群在RE中的作用机制,期望能够通过靶向肠道菌群为RE患者提供安全有效的治疗。
肠道菌群与放射性肠炎的关系及研究进展
The relationship and research progress between intestinal flora and radiation enteritis
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摘要: 肠道菌群是人体的重要组成部分。目前已经证实肠道菌群在高血压、糖尿病、肿瘤和炎症性肠病等疾病的发生发展中发挥重要作用。放射性肠炎(RE)多见于行放疗的肿瘤患者。近年来,肠道菌群与RE的关系成为研究热点。RE与肠道菌群密切相关,其机制可能与肠道菌群失调引起的炎症细胞的浸润及相关细胞因子的表达密切相关。益生菌补充治疗能够缓解部分RE患者的临床症状。最近一些研究聚焦于粪便菌群移植及小分子新药在RE中的治疗作用。笔者总结了近期基于肠道菌群的RE的发生机制及临床应用研究,期望为靶向肠道菌群的治疗提供理论依据。Abstract: Intestinal flora is an important part of human body. It has been confirmed that intestinal flora plays important roles in the occurrence and development of hypertension, diabetes, tumor and inflammatory bowel disease. Radiation enteritis (RE) is more common in patients with tumor radiation and nuclear exposure. In recent years, the relationship between intestinal flora and RE has become a research hotspot. RE was closely related with intestinal flora. The mechanism may be closely related to the infiltration of inflammatory cells and the expression of related cytokines which were caused by the imbalance of intestinal flora. Probiotics supplement therapy can partially relieve the clinical symptoms of patients with RE. Some studies are exploring the therapeutic effects of fecal bacteria transplantation and small molecule new drugs in RE. This study summarizes the recent research on the pathogenesis and clinical application of RE based on intestinal flora, hoping to provide theoretical basis for the treatment of targeted intestinal flora.
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