HPA轴功能障碍在产后抑郁症中的作用机制  

Mechanism of the hypothalamic-pituitary-adrenal axis dysfunction in postpartum depression

作　　者：陈佳丽 张燕萍 周文华[2] 张宜生[1] CHEN Jiali;ZHANG Yanping;ZHOU Wenhua;ZHANG Yisheng(Department of Gynecology and Obstetrics,Li Huili Hospital Affiliated to Ningbo University,Ningbo 315040,China;Ningbo Addiction Research and Treatment Center,Ningbo 315010,China)

机构地区：[1]宁波大学附属李惠利医院,宁波315040 [2]宁波市微循环与莨菪类药研究所,宁波315010

出　　处：《生命的化学》2021年第10期2125-2133,共9页Chemistry of Life

摘　　要：产后抑郁症(postpartum depression,PPD)是在产后4周内起病的重性抑郁发作,其发病与妊娠和产后激素变化、慢性应激以及遗传等多种因素有关。这些因素均能通过影响机体下丘脑-垂体-肾上腺皮质(the hypothalamic-pituitary-adrenal,HPA)轴参与PPD的发生发展。该文对HPA轴功能障碍在PPD发生中的病理生理机制进行了总结,从激素变化(包括生殖激素、应激激素和四氢孕酮等)、慢性应激、遗传和表观遗传学改变的角度分析了HPA轴功能障碍在PPD中的可能机制,并提出了HPA轴在治疗PPD中的潜在作用。Postpartum depression(PPD)is a major depressive episode begins within 4 weeks after delivery.Its onset is related to many factors such as hormone changes during pregnancy and postpartum,chronic stress and genetics,etc.All these factors can lead to the development of PPD by affecting the hypothalamicpituitary-adrenal(HPA)axis.From the perspectives of hormonal changes(including reproductive hormones,stress hormones and allopregnanolone,etc.),chronic stress,genetics and epigenetics,this work summarizes the pathophysiological mechanism of HPA axis dysfunction in PPD,and proposes potential targets for the treatment of PPD through the action of HPA axis.

关 键 词：产后抑郁症 下丘脑-垂体-肾上腺皮质轴 雌激素 四氢孕酮 应激 糖皮质激素受体 肠道微生物群 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R714.6[医药卫生—临床医学]