创伤后应激障碍炎症机制的研究进展

Research progress on inflammatory mechanism of posttraumatic stress disorder

创伤后应激障碍(post-traumatic stress disorder,PTSD)是一类以创伤性再体验、回避和警觉性增高为主要特征的精神障碍性疾病,对个人、家庭和社会造成严重影响。目前,临床上对于PTSD治疗主要是以5-羟色胺再摄取抑制剂等基于下丘脑-垂体-肾上腺(hypothalamic-pituitary adrenal,HPA)轴紊乱假说的药物为主,但是这些药物存在着疗效低、不良反应多和个体差异大等问题。同时,HPA轴紊乱假说也不能解释PTSD的所有临床表现。近年来,炎症假说越来越受到关注,该假说认为应激刺激可以引发机体的炎症反应,并且通过一系列机制最终导致PTSD的发生。我们主要从炎症反应的角度对PTSD的病理生理机制进行综述,为PTSD的临床治疗提出新的诊疗策略。

Post traumatic stress disorder(PTSD)is a kind of mental disorder characterized by traumatic re-experience,avoidance and heightened alertness,which has a serious impact on individuals,families and society.At present,the main treatment for PTSD is drugs based on the hypothesis of hypothalamic pituitary adrenal(HPA)axis disorder,such as serotonin re-uptake inhibitors.However,these drugs have some problems,such as low efficacy,many adverse reactions and large individual differences.At the same time,HPA axis disorder hypothesis can not explain all clinical manifestations of PTSD.In recent years,more and more attention has been paid to the inflammation hypothesis,which holds that stress stimulation can trigger the inflammatory response of the body,and eventually lead to PTSD through a series of mechanisms.We review the pathophysiological mechanism of PTSD from the perspective of inflammatory response,and proposes new diagnosis and treatment strategies for the clinical treatment of PTSD.