创伤后应激障碍(PTSD)是指机体经受巨大精神创伤之后产生的一种心理失调后遗症,因其受自然灾害和战争等因素影响,呈现特定人群高发病率,引发关注.其发病进程受多种因素影响,发生发展的机制目前尚不清楚.生物学研究表明,以下丘脑-垂体-肾上腺(HPA)轴为主体的神经内分泌系统紊乱,免疫系统失调和慢性炎症反应,以及脑解剖结构和神经环路改变在PTSD的病理进程中都发挥重要作用.临床治疗主要以症状为靶向,首选抗焦虑、抑郁药物,同时结合心理治疗,预后效果个体差异较大,更多的药物及其他治疗方法还在试验中.本综述结合国内外研究成果,尤其是PTSD患者中的神经内分泌紊乱、免疫失调和神经环路基础进行初步分析论证,为进一步揭示PTSD的病理机制及治疗提供新的思路.%Post-traumatic stress disorder (PTSD) is a mental disorder that develops after individual exposure to one or more traumatic events.Natural disasters and war are the major primers of PTSD.Tt is affracting more attention due to the high prevalence in war veterans and natural disasters.The risk factors range from gender,environment to physiology.Hypothalamic-pituitary-adrenal (HPA) axis plays an important role in stress reaction and dysfunction of HPA axis leads to disorder of neuroendocrine.In addition,chronic inflammation,including adaptive and innate immune response disorder,has been reported in many PTSD studies.Neural imaging studies have found that there are significant changes in the brain structure and neural circuits of PTSD patients.However,the biological mechanism underlying PTSD is largely unknown.Currently,based on the clinic symptoms of PTSD patients,anti-depression and anxiety drugs are the first choice for treatment,but the outcomes are diverse.Some potential therapeutic drugs or avenues that are derived from the identified targets are still under investigation.In this review,we overview and summarize the biological changes of PTSD,focusing on disorder of neuroendocrine,chronic inflammation,brain structure and circuits changes and therapeutic strategies in clinical and preclinical trials.This review aims to will provide new ideas for revelation of PTSD mechanisms and develop novel therapies.
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