20166 28 6ChinJMicroecolJun2016Vol.28No.6 621 (2016) : ; ; :R45 :A :1005-376X (2016)06-0621-11 DOI :10.13381/j.cnki.cjm.201606001 1000 [5] :(1) 10 13 ~10 14 (2) : (3) 10 12 CFU :1 / ( 1 3) [1] (3 7) 2 ; 3 B/E PCR DNA (B/E )<1 [4] 4 [2] ( (imbalanceofgutmicrobiota) [3] ) ( ) ; ( ) [4] : (1) (probiotics) (prebiotics) (synbiotics) [6] (2) 1989Fuler (3) [7] (super- 1992Fuler [8] infection) :(1) (2) (3) ( ) (4) (5) : 310003E-mail:ljli@zju.edu.cn 7
622 20166 28 6ChinJMicroecolJun2016Vol.28No.6 (non-alcoholicfatyliverdis- ; easenafld) ; (nonalcoholicsteato- ( ) hepatitisnash) [9] : (1) : [24] NAFLD [25-26] NAFLD VSL#3 (2) : NAFLD 3 VSL#3 (3) : TNF-α (4) : [27] NAFLD TNFα CRP AST (5) : [28] (6) NAFLD (7) ALT AST GGT [29] ALT γ-gt [30] NAFLD ALT [10] [31-32] NASH Lep- icol6 AST 30 [33] NASH 4 [34] DAO D- ALT NASH 3 DAO [30] NASH 3 [35] TNF-α IL-6 1 NAFLD [36] (HelicobacterpyloriH.pylori) H.pylori [37-40] H.pylori [11-13] [37] : [14] H.pylori [41] 6 [15-17] [18-20] 3 [21-22] [23] 2
20166 28 6ChinJMicroecolJun2016Vol.28No.6 623 3.3 ( ) ; [52] ; [42-43] Nature ( ) [44] [53] 4 [45-46] 17.1μmol/L 3.1 10 (PTA<49%) ( [47-48] ) 80% 30% 70% 90 [49] [50] 3.2 [54] [55] ; [56] [51] Bajaj 24% (acute on chronicliverfailure ACLF) Clostridiales XIV
624 20166 28 6ChinJMicroecolJun2016Vol.28No.6 [45] Leuconostocaceae 16SrDNA 79 AAD [57] ACLF AAD 5% ~39% [65] ACLF AAD ( 10% ~25% 15%~20% 5% ~10% ACLF 2% ~5%) AAD : (modelforend-stageliverdiseasemeld) 15%~24% 100% (IL-6TNF-αIL-2) A B (clostridium dificile associated-diarrheacdad) CDAD AAD 15%~25% AAD AAD [66-70] Susanne [66] 82 5 ( ) AAD [58] : AAD AAD [59-61] [71-72] AAD AAD 6 (irritable bowelsyndrome IBS) Treg TGF-b CD4/CD8 [62-63] + [64] [73] - IBS [60] [74-75] IBS IBS : (1) [76-77] [78-80] (2) (3) [81] [82-83] (antibiotic-associateddiar- (4) rheaaad) IBS
20166 28 6ChinJMicroecolJun2016Vol.28No.6 625 IBS HT-29 SW480 Caco-2 [97] 2011WGO [10] IBS [98] [99-102] IBS IBS [103] 9 7 [104] : (1) (inflammatory bowel disease IBD) (ulcerativecolitisuc) ( (Crohn sdiseasecd) IBD ) [84-86] VSL#3 UC (2) 5-ASA Nissle [87-88] UC (3) [89-93] ( ) + [93] [85-94] CD 8 (colorectalcancercrc) GibosonRobefroid [1] 1995 () IBS IBD [95] [96] : (1) 7α- β - β - (2) (3) (4) (5) [105] VSL#3
626 20166 28 6ChinJMicroecolJun2016Vol.28No.6 (3) 10 :1 10.1 : 1991 (ACCP) / / (SCCM) ( ) (multipleorgandys- PCR (ER1C2PCR) functionsyndrome MODS) (multipleorganfailure MOF) [106] ;2 :si- ga siga ;3 : D (systemicinflammatoryresponsesyn- (DAO) dromesirs) (L/M) [107-108] [112] MODS [109] (gas- trointestinaldysfunction GID) () () (ACCP/SCCM) (1992 ) [106] [113] 10.2 5 GID MODS 10.2.1 [110] (1995 ) GID : 1 ; 2 ; [114] 3 [115] : [111] (1) :1 SIRS/MODS MOF [116] 5d;2 ;3 10.2.2 ;4 (LPS) A (2) :1 (NO PG ) : ;2 [117-118] 24h 800mL;3 10.3 ;4
20166 28 6ChinJMicroecolJun2016Vol.28No.6 627 ; 11 FMT) [119] FMT : : (1) (clostridium dificileinfec- (EN)/ (ONS); (2) tioncdi)fmt CDI2013 FMT [120] 2 [129] FMT (PN) ; (3) : : [121] ; ; [122] ( : ) Gough [130] (MCT) [123] ; 10000 200~300g 500mL ; [131] 6h CDI FMT ; (0.5kcal/mL ) FMT FMT (20~30 ml/ 20~30 ml/h); + FMT ; FMT ; (4) FMT 10 10 ~10 12 CFU ( ) (syntheticmicrobiotatransplantationsmt) ; FMT ;(5) 12 [124] [125] 1~2;(6) (0.3~0.5g/kg d) [126] [132] ; (7) [127-128] (fecal microbiotatransplantation
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