【摘要】 目的:探讨心理应激导致抑郁时机体神经-内分泌-免疫网络平衡状态及脑海马结构的变化。资料来源:应用计算机检索Medline1992-05/2001-10的有关心理应激、抑郁症及脑海马损伤的文章,检索词“Depression,Stress”,并限定文章语言种类为English。资料选择:对资料进行初审,选取与心理应激、抑郁基础分析及脑海马损伤相关的文章,并开始查找全文。重复课题中选择大样本的实验文章、排除Mata分析类文章及综述。质量评价主要考察资料的真实性,设计过程是否严密。资料提炼:共收集到56篇有关心理应激、抑郁症及脑海马损伤的基础分析文献,排除重复或小样本的文章,23篇文献符合本课题要求。资料综合:①针对有关心理应激和抑郁症的基础分析,对所检索出文献中的众多观点进行提炼综合,重点介绍国内外的前沿观点,对抑郁症的病理基础作以较系统、深入的探索。②无论是人类或是其他生物,在面临不适于其生存的刺激即应激(而人类更要面临社会心理应激)时,必然产生紧张、焦虑、抑郁的情绪反应。而长期、慢性的应激,则可能通过一系列的神经生化机制导致脑组织,特别是脑海马结构器质性损害,并影响依赖于脑海马的认知、情绪等功能,在一些其他因素,如遗传素质的基础上诱发抑郁症。结论:慢性应激时,机体神经-内分泌-免疫网络失衡,由于一系列的神经生化改变可导致大脑器质性损害,而与情绪密切相关的边缘系统尤其是脑海马结构最易受到损害,海马损伤可能与抑郁情绪的发生有关。更多还原

【Abstract】 OBJECTIVE: To explore the equilibrium state of body nerve-endocrine- immunological network and the changes of the cerebral hippocampal formation on the condition of depression induced by psychological stress.DATA SOURCES: We searched the Medline for the articles about psychological stress, depression and cerebral hippocampus damage published between May 1992 and October 2001 with the "Depression, Stress", and the language was limited to English. STUDY SELECTION: After the first trial, those articles related to basic studies of psychological stress and depression and the cerebral hippocampus damage, and the full text was searched. The big-sample experiment articles of the repetitive topics were selected. The Mata analysis and review were excluded. The quality evaluation inspected mainly the validity of materials, and the design process whether strictness or not. DATA EXTRACTION: Totally 56 articles about the basic analysis of psychological stress, depression and cerebral hippocampus damage were collected. After the exclusion of repeated and similar studies, 23 articles were accorded with our criteria.DATA SYNTHESIS: ①Aiming at the basic studies of psychological stress and depression, the viewpoints of collected articles were summarized. The internal and overseas forward viewpoints were introduced emphatically,and the pathological mechanism of the depression were discussed further and deeply. ② No matter human or other organism, when facing the stimulation that was not suitable for living i.e. stress (Human had to face the social psychological stress), the emotional response of tension, anxiety and depression occured. The long-term, chronic stress could lead to the damage of cerebral tissue, especially the organic lesion of cerebral hippocampal formation through a series of neural biochemical mechanism, and had effects on the function of cognition and emotion etc. that depended on the cerebral hippocampus, on the basis of some other factors, e.g. hereditary predisposition, evoked the depression. CONCLUSION: The nerve-endocrine-immunological network of the body is disequilibrium on the condition of chronic stress. A series of neural biochemical alteration can lead to the cerebral organic lesion, while the limbic system closely related to the emotion, especially the cerebral hippocampal formation is easier to suffer from the lesion, and the hippocampus damage maybe has relation with the occurrence of depressive emotion.更多还原