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α-硫辛酸对脑震荡后听功能的保护作用
有学者报道脑震荡后患者遗留听功能障碍占脑震荡后遗症的23.2%,仅次于头晕、头痛,其病理表现为耳蜗微循环障碍、突触损伤等,脑震荡对听功能的损伤已逐渐引起耳鼻咽喉头颈外科医师的关注~([1-3]).
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运动相关性脑震荡研究现状
运动相关性脑震荡(Sports-Related Cerebral Concussion,SRCC)又称轻型头部损伤(Mild Head Injury,MHI),是常见运动损伤类型之一,Weber J等报道在各种运动中,MHI的发病率高达80%以上[1],特别是在拳击、跆拳道、足球、曲棍球等运动员相互紧密接触、竞技激烈的运动项目中更为多见[2].
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大鼠实验性脑震荡脑组织中NSE和GFAP表达研究
Objective To study the changes and significance of neuron specific enolase(NSE) and glial fibrilous acidic protein(GFAP) in rat cerebral concussion.Methods 80 Wistar male rats were used for animal model of cerebral concussion,which were sacrificed on the 1st,3rd, 7th,14th and 30th days after injury and the brain tissue were taken off.The expressions of NSE and GFAP were studied in the course of cerebral concussion by means of immunohistochemistry. Results Rats in 100 g group were seen the clinical manifestation for typical concussion.The pathologic changes were the cerebral vascular constriction and dilation,congestion and edema of cerebral tissue and neuronal degeneration and necrosis.NSE was increased on the 1st day,and the positive area was seen in the plasma of the neurons in the cerebral cortex and the cerebellum,and also seen in blood vessels,cerebrospinal fluid in aqueduct and interstitial matrix.NSE was obtained at peak on the 7th day,decreased on the 14th day and still raised on the 30th day.GFAP was increased on the 1st day,which the positive area was seen in the plasma of astrocytes,and obtained at peak on the 3rd day,which fiber like GFAP was in short,thick and astrocytes increased.GFAP decreased on the 7th day and obtained normal level in 30 days.Conclusion The main pathologic changes of cerebral concussion were blood circulatory disorder and nervous cells degeneration,apoptosis and necrosis.NSE and GFAP participated in the course of cerebral concussion,may play an important role in the damage of blood brain barrier, nervous cells degeneration and necrosis.
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多重性脑震荡及其后遗症研究进展
创伤性脑损伤（traumatic brain injury，TBI）的死亡率和致残率居各类创伤之首[1]．随着交通工具的不断普及，发展中国家的颅脑损伤发病率也呈急剧上升趋势．WHO预计，由交通事故所致损伤将在2020年位居全球疾病第3位[2]．脑震荡（cerebral concussion， CC）属于轻型TBI，其发生率较高，机制不明，尤其在拳击、跆拳道、橄榄球、足球、曲棍球、棒球等运动员紧密接触、竞技激烈的项目中，运动性脑震荡（sports-related cere-bral concussion，SRCC）的发病率占运动性损伤的80%～90%，在美国，保守估计1 a发生SRCC的人员约160～380万[1-5]．SRCC的特点是可以在同1位运动参与者身上发生多次性脑震荡（multiple cerebral concussion，MCC）． Richard等（1973）发现当一运动员在经历1次CC尚未恢复时又再次遭受CC后，近期会出现更严重的神经与学习记忆方面的障碍，甚至死亡；Saunders等（1984）首先将这一现象定义为二次冲击综合征（Second Impact Syndrome， SIS）[6，7]．国外报道在遭受过SRCC的运动员，其SIS发生率将上升6～9.3倍，其严重程度与受伤间隔时间有关[7，8]．大量事实证明，该类损伤虽为轻型脑损伤（mild trauma brain injury， mTBI），但常常会给伤者留下远期较持久的脑震荡综合征（post-concussion syndrome， PCS）和慢性创伤性脑病（chronic trauma encephalopathy，CTE）等渐进性神经退行性变疾病，表现为认知改变、情感异常和自杀、运动功能受损与痴呆等方面的严重损害[3-5，9]．上述各种脑损伤的近、远期后遗症，不但给伤者带来巨大痛苦，特别是新近的流行病学研究发现，发展为CTE的潜在人群正在由竞技运动参加者，向战场老兵和家庭虐待受害者扩展， CTE已成为新的社会公共卫生问题而备受关注[3-5]．随着SRCC与CTE的高发，让医学界开始反思以往的TBI研究仅重视重度脑损伤的不足，重新开始审视 mTBI 或 MCC、及其所引发的 SIS、PCS和CTE等神经退行性改变，为丰富TBI机制探究提供了新的路径[10]．
