李孟瑶,刘慧慧

肺动脉高压（pulmonary arterial hypertension，PAH）是一种肺血管疾病，其病理特征为肺血管重构和炎症反应。近年来，肠道菌群及其代谢产物在PAH中的作用逐渐成为研究热点。肠道菌群借助短链脂肪酸（short-chain fatty acids，SCFAs）、三甲胺/三甲胺N﹣氧化物（trimethylamine/trimethylamine N﹣oxide，TMA/TMAO）、5﹣羟色胺（5-hydroxytryptamine，5﹣HT）和胆汁酸（bile acids，BAs）等代谢产物，通过“肠﹣肺轴”调控宿主免疫、炎症反应及代谢平衡，从而对PAH的发生与发展产生影响。本文全面概述了肠道菌群失调通过提升肠道通透性、引发内毒素血症、诱导菌群代谢物、加速肺血管重塑、强化菌群与免疫相互作用及改善炎症微环境等机制，参与PAH的病理过程，并探讨了针对肠道菌群的创新疗法，如粪便微生物移植（fecal microbiota transplantation，FMT）、饮食干预、益生菌/益生元等。未来研究需深入解析菌群﹣代谢物﹣宿主互作网络，开发基于菌群调控的个体化治疗，为PAH的防治提供新思路。

肺动脉高压；肠道菌群；肠道菌群代谢物

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