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妊娠及产后抑郁的神经内分泌学方面

THE NEUROENDOCRINOLOGICAL ASPECTS OF PREGNANCY AND POSTPARTUM DEPRESSION.

作者信息

Trifu S, Vladuti A, Popescu A

机构信息

"Carol Davila" University of Medicine and Pharmacy - Dept. of Neurosciences, Bucharest, Romania.

University of Bucharest Faculty of Psychology and Educational Sciences - Dept. of Psychology, Bucharest, Romania.

出版信息

Acta Endocrinol (Buchar). 2019 Jul-Sep;15(3):410-415. doi: 10.4183/aeb.2019.410.

Abstract

INTRODUCTION

Ties between the endocrine system and mental health are undeniably a consistent point of interest in modern day medicine. Furthermore, mental disturbances due to hormonal changes following childbirth have been mentioned in medical literature since Hippocrates. Considering the dramatic endocrine, paracrine and autocrine changes that occur during gestation, labour and postnatal phase, hormonal theories are not to be ignored in the treatment of postpartum disorders.

RESULTS

Reproductive hormones are known to modulate behavioural, emotional and cognitive response, therefore rapid changes in estradiol and progesterone plasma concentrations during pregnancy and labour create a vulnerable terrain leading towards postpartum disorders. New research shows that women suffering from postpartum disorders have abnormal neural responses, suggesting a neuroendocrine explanation for postpartum syndromes.

CONCLUSION

To facilitate further research in this area, we present new information on several hormonal interactions and the psychiatric response involved in pregnancy and labour, offering an interdisciplinary outlook on pregnancy and postpartum disorders. There is enough evidence to suggest that estradiol, progesterone, oxytocin, cortisol and thyroid hormones are some of many hormones involved in postpartum syndromes and tackling their perinatal imbalance with pharmacological substituents or antagonists could be useful as an adjuvant form of treatment in future patients.

摘要

引言

内分泌系统与心理健康之间的联系无疑是现代医学中一个持续受到关注的焦点。此外,自希波克拉底时代起,医学文献中就提及了产后激素变化引起的精神障碍。鉴于妊娠、分娩和产后阶段会发生显著的内分泌、旁分泌和自分泌变化,激素理论在产后疾病的治疗中不容忽视。

结果

已知生殖激素可调节行为、情绪和认知反应,因此孕期和分娩期间雌二醇和孕酮血浆浓度的快速变化会形成一个易引发产后疾病的脆弱环境。新研究表明,患有产后疾病的女性存在异常的神经反应,这为产后综合征提供了一种神经内分泌学解释。

结论

为推动该领域的进一步研究,我们提供了有关妊娠和分娩过程中几种激素相互作用及精神反应的新信息,呈现了关于妊娠和产后疾病的跨学科观点。有足够的证据表明,雌二醇、孕酮、催产素、皮质醇和甲状腺激素是参与产后综合征的众多激素中的一部分,用药物替代物或拮抗剂解决它们在围产期的失衡问题,可能会成为未来患者辅助治疗的一种有用方式。

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