卒中后抑郁的病理生理机制及其临床干预的研究进展  

Research Advance in the Pathophysiological Mechanism and Clinical Intervention of Post-Stroke Depression

作　　者：肖展宏[1] 庞晓敏 韦宗勇 

机构地区：[1]南宁市第一人民医院康复医学科,南宁530022

出　　处：《医学综述》2017年第23期4683-4687,共5页Medical Recapitulate

基　　金：广西科学研究与技术开发计划项目(桂科攻14124003-6)

摘　　要：卒中后抑郁(PSD)是脑卒中发病后常见的心境障碍,严重影响脑卒中患者的功能恢复和生命质量。PSD的病理生理机制尚未完全明确,涉及单胺能系统异常、额叶-皮质下回路损伤、下丘脑-垂体-肾上腺轴激活、神经炎症以及神经营养因子信号通路等神经生物学过程,心理因素在整个发病过程中亦发挥关键作用。目前对于PSD尚无特异性的治疗方法,临床上常用的治疗方法包括药物治疗、心理治疗、物理治疗、传统医学治疗等,但这些治疗方案尚不能系统、规范的普及。故进一步深入研究PSD的发生机制、优化治疗方案,对改善预后具有重要意义。Post-stroke depression （PSD） is a common mood disorder after stroke onset, seriously affecting the functional recovery and quality of life of the patients. The pathophysiological mechanism of PSD is not yet clear,which involves neurobiological processes such as abnormalities of monoamine system, frontal lobe-subcortical circuit injury, hypothalamicpituitary-adrenal axis activation, neuroinflammation and neurotrophic factor signaling pathway. The psychological factor also plays a key role in the whole process of disease. At present, there is no specific treatment for PSD, commonly used clinical treatments include drug therapy, psychological treatment, physical therapy, and traditional medical treatment etc. , but these treatment programs are not systematic, standardized popularized yet. Therefore, further study of the mechanism of PSD, optimization of the treatment programs, are of great significance to improve the prognosis.

关 键 词：卒中后抑郁 发病机制 神经生物学 社会心理学 药物治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]