经前期综合征患者HPA轴功能失调的机制

Hypothalamic-Pituitary-Adrenal Axis Dysfunction in Individuals with Premenstrual Syndrome and its Mechanism

经前期综合征(premenstrual syndrome,PMS)患者下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal,HPA)轴功能失调的机制涵盖生理、心理、社会多方面因素。文章从生理-社会-心理交互作用的角度出发,在回顾文献的基础上对PMS与HPA轴功能失调之间的关系进行分析。发现女性在经前期具有对压力敏感的生理基础,并且在社会文化的构建下,PMS患者相较于非PMS者有更强的负性月经态度,导致其经前期主观感知压力增加。而PMS患者缺乏相应的压力应对能力,所以周期性经前期压力处理失败导致PMS患者HPA轴功能的压力反应失调,即在心理性压力源下出现皮质醇分泌水平较低的现象,从而形成固定化的PMS反应模式。

The mechanism of hypothalamic-pituitary-adrenal(HPA)axis dysfunction in patients with premenstrual syndrome(PMS)covers physiological,psychological,and social factors.From the perspective of physiological-social-psychological interaction,this article summarized the relationship between PMS and HPA axis dysfunction and its pathogenesis.The results found that women have a physiological basis for pressure sensitivity during the premenstrual period,and under the construction of social culture,patients with PMS have a stronger negative menstrual attitude than individuals without PMS,which leads to an increase in their subjective perceived stress during the premenstrual period.However,patients with PMS lack the corresponding stress coping ability,and failures of coping with periodic premenstrual stress lead to stress reaction dysfunction of HPA axis in patients with PMS,that is the phenomenon of low cortisol secretion under psychological stressors,thus forming an immobilized PMS reaction mode.