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Review Article

重症监护中的微生物群：一个非常规和未知的盟友

卷 29, 期 18, 2022

发表于: 13 January, 2022

页: [3179 - 3188] 页: 10

弟呕挨: 10.2174/0929867328666210915115056

价格: $65

摘要

背景：消化道是外部环境和身体之间的界面，其中复杂的多微生物生态学的相互作用对健康和疾病有重要影响。住院期间和重症监护病房(ICU)中改变的生理机制有助于病原群的生长。入院后数小时内发生肠道生态失调。这可能是由于不同的因素，如正常肠道运输的改变，各种药物的管理，或肠壁的改变，导致一连串的事件，将导致硝酸盐的增加和氧浓度的减少，和自由基的释放。 目的：本研究旨在报道微生物群对重症监护科患者脓毒症发展的最新进展。在这篇简短的综述中，我们回顾了关于肠道免疫防御的局部和系统机制的最新科学发现。此外，我们认为有必要在对危重患者的微生物群进行的众多研究的基础上回顾文献，以预防这些患者感染的传播。 材料与方法：本文旨在回答四个主要问题： 1-肠道菌群的主要防御系统帮助我们预防系统性疾病的风险？ 2-生态失调的主要全身性异常是什么？ 3-ICU预防感染传播的现代策略是什么？ 4-Covid-19与微生物群之间的关系是什么？ 我们回顾了72篇文章使用以下关键词：“微生物群”和“微生物群”和“重症监护”，“重症监护”和“肠道”，“危重疾病”，“微生物群”和“重症护理”，“微生物群”和“脓毒症”，“微生物群”和“感染”，和“胃肠道免疫”：科克伦对照试验注册，科克伦图书馆， Medline and Pubmed, Google Scholar, Ovid/Wiley。此外，我们还咨询了ClinicalTrials.com网站，以找出最近已经进行或正在进行的研究。 结果：危重病可改变肠道菌群，导致内稳态失衡。尽管许多机制，如上皮细胞与钙化细胞一起构建一个机械屏障致病细菌，粘液相关淋巴组织（麦）刺激免疫反应通过生产干扰素伽马(IFN-y)和THN-a或或生产淋巴细胞Telper产生的抗炎细胞因子2。但这些防御可以改变在ICU住院后，导致严重的并发症，如急性呼吸窘迫综合征(ARDS)、医疗保健相关肺炎(HAP)和呼吸机相关肺炎(VAP)，全身感染和多器官衰竭(MOF)，也冠状动脉疾病(CAD)的发展。此外，该微生物群对肠道并发症的发展和sars-covid-19患者的严重程度也有显著影响。 结论：微生物群被认为是使重症监护病房中已经非常虚弱的患者临床病情恶化的重要因素之一。同时，微生物群在预防icu相关并发症中也起着至关重要的作用。通过利用现有的资源，如益生菌、合生菌或粪便微生物群移植(FMT)，我们可以保持微生物群和肠道的完整性，这将有助于维持ICU患者的稳态。

关键词: 微生物群和ICU、ICU和肠道、微生物群和危重症、微生物群和危重症护理、脓毒症、感染、胃肠道免疫、SARS-COVID-19。

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