抑郁症与阿尔茨海默病共病关系及干预方式探析

Analysis of Comorbidities between Depression and Alzheimer’s Disease and Intervention Methods

摘要: 阿尔茨海默病(Alzheimer’s disease, AD)是一种神经退行性疾病，主要表现为认知障碍；抑郁症(Major Depressive Disorder, MDD)，是一种常见的精神障碍疾病，且现已证明AD与MDD二者之间存在紧密关系，二者有一定的共同发病机制。抑郁因素作为AD的十二大危险因素之一，现如今研究不断证明着AD患者在前期会呈现有抑郁状态的生理表现。AD的治疗方法研究虽已取得许多进步，但目前仍无治疗的药物，而MDD现已有药物治疗方法，故有研究开始以基于两者共同病理学的基础来进行AD伴发MDD的药物治疗方法，以及从生理性的非药物干预方法。故此探究AD与MDD基于共同的淀粉样蛋白、五羟色胺(5-hydroxytryptamine, 5-HT)、星形细胞、糖皮质激素(Glucocorticoid, GC)及其受体(Glucocorticoid receptor, GR)以及载脂蛋白E (Apolipoprotein E, ApoE) є4等位基因的病理生理学基础，并从AD与MDD的共同病理生理学机制来进行AD与MDD的药物与非药物干预。本文以文献综述的方法，探讨AD与MDD的共同病理生理及其药物与非药物干预的机制，结果发现AD与MDD有极大的共同病理生理学机制。结论是可通过选择性5-HT再摄取抑制剂、降胆固醇药物、谷氨酸受体拮抗剂等药物干预治疗AD伴发MDD患者，通过心理干预、情绪干预、运动干预、音乐干预的非药物干预的方式来缓解与治疗AD与MDD。

Abstract: Alzheimer’s disease (AD) is a neurodegenerative disease characterized by cognitive impairment. Major Depressive Disorder (MDD) is a common mental disorder, and it has been proved that there is a close relationship between AD and MDD, and they have a certain common pathogenesis. As one of the 12 major risk factors for AD, current studies have constantly proved that AD patients will present physiological manifestations of depression in the early stage. Although a lot of progress has been made in the research on the treatment of AD, there are still no drugs for the treatment of MDD, while there are drug treatment methods for MDD. Therefore, some studies have begun to carry out drug treatment methods for AD with MDD based on the common pathology of the two, as well as physiologic non-drug intervention methods, therefore, to explore the common amyloid protein, 5-hydroxytryptamine (5-HT), astrocytes, Glucocorticoid (GC) and Glucocorticoid receptor based on AD and MDD (GR) and Apolipoprotein E (ApoE) 4 allele, and from the common pathophysiological mechanism of AD and MDD to carry out the drug and non-drug intervention of AD and MDD. This article reviewed the literature to explore the common pathophysiology of AD and MDD and the mechanism of drug and non-drug intervention. The results showed that AD and MDD have a great common pathophysiology. The conclusion is that AD patients with MDD can be treated by selective 5-HT reuptake inhibitors, cholesterol-lowering drugs, glutamate receptor antagonists and other drug interventions, and non-drug interventions such as psychological intervention, emotional intervention, exercise intervention and music intervention can alleviate and treat AD and MDD.