精神障碍与生殖系统疾病共病机制研究新进展

doi:10.12280/gjszjk.20260024

摘要/Abstract

摘要：

精神障碍与生殖系统疾病同属全球重大公共卫生挑战，二者在临床上常高度共病，相互影响并形成恶性循环。研究证实，精神障碍与女性不孕症、多囊卵巢综合征、子宫内膜异位症、卵巢储备功能减退、反复着床失败、复发性流产以及男性不育症之间存在共同的病理生理机制，其核心机制主要涉及下丘脑-垂体-肾上腺轴与交感神经系统功能紊乱所致的激素失衡、免疫炎症激活与细胞因子谱改变、氧化应激对配子与胚胎的损伤、表观遗传调控异常以及微生物菌群-肠-脑轴的潜在影响。这些机制交织构成复杂网络，既揭示了精神障碍作为生殖系统疾病独立危险因素的生物学本质，也阐明了生殖系统疾病反向增加精神障碍易感性的病理生理过程，但精神障碍与生殖系统疾病共病的具体机制仍未完全明确。综述近年上述共病机制的最新研究进展，为深入理解二者内在生物学联系，开发跨学科的精准诊疗策略提供理论依据。

关键词: 精神障碍, 生殖器疾病, 女（雌）性, 不育, 男（雄）性, 共病现象, 免疫因子类, 氧化性应激, 表观基因组学

Abstract:

Both mental disorders and reproductive system diseases represent major challenges of global public health. The two conditions frequently co-occur clinically, mutually influencing each other and forming a vicious cycle. Research confirms that mental disorders share common pathophysiological mechanisms with female infertility, polycystic ovary syndrome, endometriosis, diminished ovarian reserve, recurrent implantation failure, recurrent spontaneous abortion, and male infertility. The core mechanisms primarily involve hormonal imbalance caused by dysfunction of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system, activation of immune inflammation and alterations in the cytokine profile, oxidative stress damage to gametes and embryos, abnormal epigenetic regulation, and potential effects of the microbiota-gut-brain axis. These mechanisms intertwine to form a complex network, revealing both the biological nature of mental disorders as independent risk factors for reproductive system diseases, and elucidating the pathophysiological processes through which reproductive system diseases conversely increase susceptibility to mental disorders. However, the specific mechanisms underlying the comorbidity of mental disorders and reproductive system diseases are not completely clear. We review the research progress in the aforementioned comorbidity mechanisms, providing a theoretical basis for deepening our understanding of their intrinsic biological connections and developing interdisciplinary precision diagnosis and treatment strategies.

Key words: Mental disorders, Genital diseases, female, Infertility, male, Comorbidity, Immunologic factors, Oxidative stress, Epigenomics

卫倩, 何玉洁. 精神障碍与生殖系统疾病共病机制研究新进展[J]. 国际生殖健康/计划生育杂志, 2026, 45(3): 236-241.

WEI Qian, HE Yu-jie. Research Progress on Comorbidity Mechanisms of Mental Disorders and Reproductive System Diseases[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(3): 236-241.

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