潮热发病机制中雌激素对肾上腺素能受体表达的调控作用

王 荣, 刘 改文
内蒙古医科大学

摘要

潮热是是围绝经妇女最典型的症状，严重时会明显影响女性的生活质量。目前公认潮热的发生机制为中枢体温调节热中性带（thermoneutral zone）变窄学说 [1，2,3] 。1963 年，Feldberg 和Myers [4] 首次发现去甲肾上腺素和5-HT 在下丘脑视前区的平衡状态决定体温调定点水平的高低。去甲肾上腺素是降低体温调定点和触发潮热的重要神经递质，雌激素是缓解围绝经期潮热症状最有效的药物，有研究发现雌激素对肾上腺素能受体具有调节作用，由此推测雌激素对脑内肾上腺素能受体的调节作用可能是潮热发生的主要机制之一。本文就潮热发病机制中雌激素与肾上腺素能受体可能的相互作用作一综述。

关键词

肾上腺素能受体；雌激素；雌激素替代疗法；围绝经期；潮热

参考

[1]Freedman RR.Krell W.Reduced thermoregulatory null zone inpoetmenopausal women with hot flashes[J].Am J Obstet Gynecol,1999,181(1):66-70.

[2]Freedman RR.Pathophysiology and treatment of menopausal hot flashes[J].Semin Reprod Med,2005,23(2):117-125.

[3]Freedman RR.Menopausal hot flashes:mechanisms,endocrinology,treatment[J].J Steroid Biochem Mol Biol,2014,142:115-120.

[4]Feldberg W.Myers RD.A New Concept of Temperature Regulation byAmines in the Hypothalamus[J].Nature,1963,200(4913):1325-1325.

[5]Freedman RR,Dinsay R.Clonidine raises the sweating threshold in symp-tomatic but not in asymptomatic postmenopausal women.[J].Fertil Steril,2000,74(1):20-23.

[6]McEwen B S, Alves S E. Estrogen actions in the central nervous system[J].Endocr Rev, 1999,20(3):279-307.

[7]Jin F,Tao M, Teng Y,et al.Knowledge and attitude towards menopause and hormone

[8]Lobo R A.Hormone-replacement therapy: current thinking.[J].Nature Reviews Endocrinology, 2016.

[9]Keating, Nancy L. Use of Hormone Replacement Therapy by Post-menopausal Women in the United States[J]. Annals of Internal Medicine, 1999,130(7):545.