肠道微生物及其代谢物与脑血管疾病关系的研究进展
Research Progress on the Relationship between Gut Microbiota and Its Metabolites and Cerebrovascular Diseases
DOI: 10.12677/acm.2025.15123635, PDF,    科研立项经费支持
作者: 叶铖龙：绍兴文理学院医学院，浙江 绍兴；王建莉*：绍兴市人民医院神经外科，浙江 绍兴
关键词: 脑血管疾病；脑出血；脑卒中；肠道微生物；肠道菌群失调；微生物代谢物；Cerebrovascular Disease； Intracerebral Hemorrhage； Stroke； Gut Microbiota； Gut Dysbiosis； Microbial Metabolites
摘要: 脑血管疾病的发病机制尚未完全明确，肠道菌群失调可能在其发展过程中发挥作用。本文通过综述相关研究发现，高血压患者肠道菌群多样性显著降低，且高血压患者的肠道菌群可导致无菌小鼠血压升高。以普雷沃菌(Prevotella)和克雷伯菌(Klebsiella)为代表的促炎菌群过度增殖，而产短链脂肪酸的有益菌(如Faecalibacterium和Roseburia)减少。脑卒中患者肠道菌群多样性也大幅降低，特定菌群(如链球菌、乳酸菌)增多，而有益菌(如罗斯氏菌、真杆菌)减少。其他脑血管疾病患者中的肠道菌群也存在着异常的改变，如肠道菌群代谢通路中，GBPA-吡哆醛5磷酸生物合成I途径(OR = 1.48)显著增加SAH发病风险。肠道微生物通过合成生物活性代谢物影响宿主的生理功能，进而导致脑血管疾病发生，主要涉及的有三甲胺N-氧化物、脂多糖、色氨酸、短链脂肪酸等代谢物。越来越多的证据支持肠道菌群失调与脑血管疾病之间的因果关系，明确肠道菌群的异常改变可能为寻找治疗靶点提供线索。
Abstract: The pathogenesis of cerebrovascular diseases remains incompletely understood, and gut microbiota dysbiosis may play a role in its development. This review summarizes relevant studies indicating that patients with hypertension exhibit a significant reduction in gut microbiota diversity, and transplantation of gut microbiota from hypertensive patients into germ-free mice can elevate blood pressure in these animals. Pro-inflammatory bacteria such as Prevotella and Klebsiella are overrepresented, while beneficial short-chain fatty acid-producing bacteria like Faecalibacterium and Roseburia are reduced. Similarly, stroke patients show a marked decrease in gut microbiota diversity, with an increase in specific bacteria such as Streptococcus and Lactobacillus, and a decrease in beneficial bacteria like Roseburia and Eubacterium. Abnormal alterations in gut microbiota are also observed in patients with other cerebrovascular diseases. For instance, within gut microbial metabolic pathways, the GBPA-pyridoxal 5’-phosphate biosynthesis I pathway (OR = 1.48) is significantly associated with an increased risk of subarachnoid hemorrhage (SAH). Gut microbes influence host physiological functions by producing bioactive metabolites—such as trimethylamine N-oxide, lipopolysaccharide, tryptophan, and short-chain fatty acids—thereby contributing to the development of cerebrovascular diseases. Growing evidence supports a causal relationship between gut microbiota dysbiosis and cerebrovascular diseases, and elucidating these microbial alterations may provide clues for identifying therapeutic targets.
文章引用：叶铖龙, 王建莉. 肠道微生物及其代谢物与脑血管疾病关系的研究进展[J]. 临床医学进展, 2025, 15(12): 2127-2135. https://doi.org/10.12677/acm.2025.15123635

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