【摘要】 脑卒中严重危害人类健康,是我国单一病种致死与致残首因.预防脑卒中事件及其并发症,改善患者疾病结局,是神经病学领域的研究重点.肠道菌群可通过免疫、内分泌和神经等通路,直接或间接影响大脑功能和宿主行为.最新研究表明,脑卒中发生前基础疾病,急性期脑缺血事件,以及卒中后并发症,均与肠道菌群紊乱存在因果关联.本综述讨论了肠道菌群在脑卒中危险因素例如肥胖、糖尿病、高血压与动脉粥样硬化等疾病中的病因角色;急性缺血性脑卒中存在由脑到肠,再由肠到脑的因果交互驱动新机制;肠道菌群及其代谢产物参与了脑卒中相关并发症,如脑卒中后抑郁、认知障碍、感染与睡眠障碍等研究进展.此外,益生菌干预等新型疗法有潜力改善脑卒中危险因素、事件与并发症的结局,但仍需进一步的基础与临床研究探究益生菌的作用机制与应用价值.脑卒中系列疾病中大脑与肠道存在互作机制,肠道菌群及其代谢物扮演了重要角色,阐明脑-肠轴相关机制对脑卒中及其并发症的预防、诊断和治疗具有重要意义.更多还原

【Abstract】 Stroke is a major health concern and the leading cause of death and disability in China. Preventing stroke and its complications and improving the outcome of stroke are crucial clinical issues in neurology. The gut microbiota may directly or indirectly affect brain function and host behavior through immune, endocrine, and neuronal pathways. Recent research reveals that pre-stroke diseases,acute cerebral ischemic events, and post-stroke complications are all causally related to gut microbiota dysbiosis. In this review, we discuss the etiological role of gut microbiota in risk factors for stroke, including obesity, diabetes, hypertension and atherosclerosis.We describe the recently discovered causal relationship between the brain-gut axis and acute ischemic stroke. We also summarize research progress regarding the gut microbiota and its metabolites as they relate to the main complications of stroke, including poststroke depression, cognitive impairment, infection and sleep disorders. Novel therapies such as probiotic interventions have the potential to improve the outcome of stroke risk factors, events and complications, but further basic and clinical studies are required to explore their mechanism and application value. The brain and gut interact through various mechanisms in several stroke-related diseases, in which the gut microbiota and its metabolites may play important roles. Exploring the mechanism of the brain-gut axis is significant in the prevention, diagnosis and treatment of stroke and its complications.更多还原