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[甲状腺的心理神经免疫内分泌学]

[Psycho-immuno-endocrinology of the thyroid gland].

作者信息

Šterzl Ivan, Absolonová Karolína, Matucha Petr

出版信息

Vnitr Lek. 2016 Fall;62(9 Suppl 3):107-114.

Abstract

Historically endocrinologists and psychiatrists are aware that disturbances in thyroid disease in beginning or even in clinically intensified states of thyrotoxicosis or hypothyroidism exhibit pathological mental manifestations, masking or potentiating the underlying disease. Immune system disorders cause thyroid organ-specific autoimmune process. This autoimmune thyroid disease binds with a number of disorders in both endocrine or non-endocrine organs. This appears in vascular, neurological, skin, connective tissue, gastrointestinal tract and mental pathology. These disorders are part of autoimmune polyglandular syndromes (APS) type I -III, especially the APS type III. Originally it was assumed that these mental disorders are caused by direct exposure to excess or deficiency of thyroid hormones. Recently, however, it appears that these psycho-immune-endocrine disorders have common etiologic mechanisms of formation and on cellular and molecular level they involve similar, if not in some cases, common mechanisms.Key words: antithyroid peroxidase antibody - autoimmune polyglandular syndrome type I., II., III. - autoimmune thyroid disease - bipolar disorder - depression - Hashimotos encephalopathy - postpartum psychosis - psycho-immuno-endocrinology - schizophrenia.

摘要

从历史上看,内分泌学家和精神科医生都知道,在甲状腺疾病初期,甚至在甲状腺毒症或甲状腺功能减退的临床加重状态下,甲状腺疾病的紊乱会表现出病理性精神症状,掩盖或加重潜在疾病。免疫系统紊乱会引发甲状腺器官特异性自身免疫过程。这种自身免疫性甲状腺疾病与内分泌或非内分泌器官的多种紊乱相关。这表现在血管、神经、皮肤、结缔组织、胃肠道和精神病理学方面。这些紊乱是自身免疫性多腺体综合征(APS)Ⅰ-Ⅲ型的一部分,尤其是APSⅢ型。最初人们认为这些精神障碍是由直接接触过量或不足的甲状腺激素引起的。然而,最近发现这些心理-免疫-内分泌紊乱具有共同的病因形成机制,在细胞和分子水平上,它们涉及相似的机制,甚至在某些情况下是相同的机制。关键词:抗甲状腺过氧化物酶抗体 - 自身免疫性多腺体综合征Ⅰ型、Ⅱ型、Ⅲ型 - 自身免疫性甲状腺疾病 - 双相情感障碍 - 抑郁症 - 桥本脑病 - 产后精神病 - 心理-免疫-内分泌学 - 精神分裂症

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