抑郁症的炎症机制及诊疗新策略

发布时间：2018-03-04 18:08

本文选题：炎症　切入点：细胞因子　出处：《生理学报》2017年05期 　论文类型：期刊论文

【摘要】：抑郁症是一类重要的精神心理疾病,其因高患病率、高致残性和高疾病负担等特征成为困扰全球的严重健康问题。一般认为,抑郁症的病因是多方面的,与性别差异、慢性应激、饮食行为方式及药物、酒精的滥用等有关。目前关于该疾病的具体病理生理机制仍未明确,研究者提出了诸如单胺能神经递质紊乱、下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal,HPA)轴功能紊乱、神经营养因子以及细胞因子等学说。基于最新研究证据以及临床工作中传统抗抑郁药效果不佳的客观事实,细胞因子学说近年来备受关注。现阶段关于细胞因子在抑郁症发病中的作用与机制研究主要集中在促炎细胞因子,尤其是肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)以及白细胞介素-6(interleukin-6,IL-6)等。随着国内外研究的深入开展,越来越多新分子、新机制被不断揭示。本文从炎症反应的角度对抑郁症发生和发展的病理生理机制进行综述,针对目前临床抗抑郁治疗的低应答率现状,提出新的诊疗策略,即抑郁症患者入院时检测炎症反应水平,对高炎患者联合使用抗炎治疗,旨在解决由于高炎状态导致应答率不理想的难治性抑郁症。
[Abstract]:Depression is an important kind of mental and psychological disease, and its characteristics such as high prevalence, high disability and high burden of disease have become serious health problems in the world. It is generally believed that the etiology of depression is various and different from gender. Chronic stress, dietary behavior, drug abuse, alcohol abuse, etc. The specific pathophysiological mechanisms of the disease are still unclear, and researchers suggest disorders such as monoaminergic neurotransmitters. Hypothalamic-pituitary-adrenal hypothalamic-pituitary-adrenal hypothalamic-HPA (hypothalamic-pituitary-adrenal) axis dysfunction, neurotrophic factors and cytokines. Cytokine theory has attracted much attention in recent years. At present, the role and mechanism of cytokines in the pathogenesis of depression are mainly focused on pro-inflammatory cytokines. Especially tumor necrosis factor- 伪 (TNF- 伪), interleukin-1 尾 interleukin-1 (IL-1 尾) and interleukin-6 (IL-6). This article reviews the pathophysiological mechanism of the occurrence and development of depression from the angle of inflammatory reaction, and puts forward a new diagnosis and treatment strategy in view of the current low response rate of clinical antidepressant therapy. That is to say, the patients with depression were treated with anti-inflammatory therapy combined with anti-inflammatory therapy when they were admitted to hospital, in order to solve the refractory depression caused by the unsatisfactory response rate caused by Gao Yan state.
【作者单位】：第二军医大学心理与精神卫生学系应激医学研究室;全军精神医学中心中国人民解放军第102医院;
【基金】：supported by grants from the National Natural Science Foundation of China (No. 81571169) the Military Medical Research Project of China (No. AHJ16J001)
【分类号】：R749.4

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