罗 永,尹毅霞,郭若琳,王 荣

重症急性胰腺炎（severe acute pancreatitis，SAP）以全身多器官功能衰竭为特征，常合并急性肾功能损伤（acute kidney injury，AKI），SAP合并AKI显著增加患者死亡率。目前对于SAP-AKI治疗研究主要有血液净化，缺少更经济，简单的治疗方法。本文通过综述相关临床研究及文献，探讨双歧杆菌四联活菌对SAP-AKI的治疗潜力及其对炎症因子IL-10和TNF-α表达的影响。研究发现，SAP患者肠道菌群失调表现为益生菌（如双歧杆菌）减少、致病菌增加，这种失衡通过加剧炎症反应和肠道屏障损伤促进病情恶化。双歧杆菌四联活菌可通过调节肠道菌群，抑制促炎因子TNF-α释放，并促进抗炎因子IL-10分泌，从而改善全身炎症反应和肾功能损伤。动物及临床研究显示，其治疗能显著降低TNF-α水平、升高IL-10水平，与临床症状改善和生存率提高相关。此外，IL-10与TNF-α的动态变化可作为SAP-AKI预后评估的潜在生物标志物。本文为双歧杆菌四联活菌的临床应用提供了理论依据，为炎症炎症因子预后判断的价值提供参考。

双歧杆菌四联活菌；重症急性胰腺炎；急性肾功能损伤；IL-10；TNF-α

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