摘要
卒中后抑郁(post-stroke depression,PSD)是卒中患者最常见的并发症之一,不仅会阻碍患者的康复进程,降低整体生活质量,而且会增加其病死率和卒中复发的风险。卒中能够引发肠道微生物群失调,而肠道微生物群失调可通过肠-脑轴的相互作用,促进抑郁的发生。目前关于PSD发病机制的理论主要涉及下丘脑-垂体-肾上腺轴(hypothalamic-pituitary-adrenal axis,HPA轴)的激活、神经递质和神经营养因子的改变、微生物代谢产物的改变、迷走神经通路和免疫炎症反应等。而益生菌可通过抑制炎症反应、调节神经递质、提高脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平和抑制HPA轴功能亢进等方面发挥抗抑郁作用。目前尚缺乏研究探讨PSD与肠道微生物群失调的相关性以及益生菌在缓解抑郁症状方面的潜在治疗益处。本文总结了PSD与肠道微生物群的相关性,并结合目前益生菌的研究现状,进一步阐述了益生菌抗抑郁的机制,分析益生菌治疗PSD的可行性,旨在为PSD的治疗提供新思路。
Post-stroke depression(PSD)is one of the most common complications in stroke patients,which not only hinders the rehabilitation process of patients,reduces the overall quality of life,but also increases the risks of mortality and stroke recurrence.Stroke can trigger the imbalance of gut microbiota,and gut microbiota disorder can form a harmful cycle through the interaction of gut-brain axis and promote the occurrence of depression.The current theories on the pathogenesis of PSD mainly involve the activation of HPA axis,changes of neurotransmitters and neurotrophic factors,changes of microbial metabolites,vagus nerve pathway,and immune inflammatory response,etc.Probiotics can play an antidepressant role by inhibiting inflammatory response,regulating neurotransmitters,increasing brain-derived neurotrophic factor(BDNF)level and inhibiting HPA axis hyperfunction.There is a lack of studies investigating the association between PSD and gut microbiota dysregulation and the potential therapeutic benefits of probiotics in alleviating depressive symptoms.This review summarized the correlation between PSD and gut microbiota,and combined with the current status of research on probiotics,further elaborated the possible mechanism of probiotics in the treatment of depression,and analyzed the feasibility of treating PSD with probiotics,aiming to provide new ideas for the treatment of PSD.
作者
金霞霞
董文迪
闫咏梅
周锋
常凯乐
JIN Xiaxia;DONG Wendi;YAN Yongmei;ZHOU Feng;CHANG Kaile(National Resource Center for Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China;不详)
出处
《中国微生态学杂志》
北大核心
2025年第6期735-740,F0003,共7页
Chinese Journal of Microecology
基金
国家自然科学基金(81973843)
陕西省教育厅2021年度重点科研计划项目(21JS016)
陕西中医药大学学科创新团队建设项目(2019-YL03)。
关键词
卒中后抑郁
肠道微生物群
机制
益生菌
抗抑郁
Post-stroke depression
Gut microbiota
Mechanism
Probiotics
Anti-depression
