帕金森病相关便秘的肠道微生态研究进展

Recent Advances in Gut Microecological Research on Parkinson’s Disease-Related Constipation

摘要: 帕金森病(Parkinson’s disease, PD)是一种常见于中老年人的神经系统变性疾病，除运动症状外，非运动症状如便秘在疾病早期即可出现，并随病程进展逐渐加重。近年来研究表明，便秘不仅是PD的前驱表现之一，其严重程度还与认知功能衰退密切相关。肠道微生态失调在PD便秘的发生发展中起关键作用，异常聚集的α-突触核蛋白可能经肠神经系统通过迷走神经途径传播至中枢，构成“肠脑轴”病理机制的核心环节。本文围绕PD相关便秘的临床表现、流行病学特征、病理生理机制、影响因素及治疗策略进行综述，重点探讨肠道菌群失调与PD便秘的相互作用及其临床意义，以期为PD的早期干预与综合管理提供新思路。

Abstract: Parkinson’s disease (PD) is a neurodegenerative disorder commonly affecting middle-aged and elderly individuals. In addition to its hallmark motor symptoms, non-motor manifestations such as constipation may emerge in the early stages of the disease and tend to worsen as PD progresses. Recent studies indicate that constipation is not only one of the prodromal features of PD, but its severity is also closely associated with cognitive decline. Increasing evidence suggests that disturbances in the gut microecosystem play a pivotal role in the onset and progression of PD-related constipation. Misfolded α-synuclein aggregates may originate within the enteric nervous system and propagate to the central nervous system via the vagal pathway, forming a core component of the “gut-brain axis” pathological mechanism. This review summarizes the clinical features, epidemiology, pathophysiology, influencing factors, and therapeutic strategies of PD-associated constipation, with a particular emphasis on the interplay between gut microbiota dysbiosis and constipation in PD. We aim to provide new insights that may contribute to early intervention and integrated management of PD.