竞技风险神经科学运动相关性轻型脑损伤与慢性创伤性脑病研究.docVIP

竞技风险神经科学运动相关性轻型脑损伤与慢性创伤性脑病研究 　　摘 要：以竞技风险为视角，从流行病学、临床表现、病理分析和神经影像学4个方面对运动相关性轻型脑损伤及与之密切相关的慢性创伤性脑病（CTE）研究进行述评。主要观点有：（1）在运动员人群中具有运动相关性轻型脑损伤经历的人数较多，该类损伤的重复性易引起CTE，发病运动员集中在拳击、足球等有身体接触性的运动项目中；（2）在CTE的病理分析中发现脑重量减轻、P-tau免疫阳性的NFT、TDK-43阳性神经突起、星形胶质细胞增生等特异性表现；（3）提出了运动相关性轻型脑损伤与CTE的分期、分类诊断标准，但仍需要大量实验来支持；（4）在神经影像学上主要采用DTI、fMRI和SWI等技术对运动员患者进行检测；（5）当前主要以运动员患者的回顾性研究为主，相关研究的突破需要开展进一步前瞻性工作。建立理想动物模型、研制特异性生物标志物等是解决目前研究瓶颈的主要途径，并要加强对运动员CTE风险?A防的研究。 　　关 键 词：运动医学；神经系统；运动相关性轻型脑损伤；慢性创伤性脑病；竞技风险；运动员 　　中图分类号：G804.5 文献标志码：A 文章编号：1006-7116（2018）01-0137-08 　　Abstract： From the perspective of competitive risks， in such 4 aspects as epidemiology， clinical manifestation， pathological analysis and neuroimaging science， the authors collated and reviewed researches in the area of sport related mild brain injury and chronic traumatic encephalopathy （CTE） that is closely related to it. There were the following main opinions： 1） among athletes there were quite a number of people who had an experience of sport related mild brain injury， the repeatability of such a type of injury tended to cause CTE； the suffered athletes were mostly in body contacting sports events such as boxing and football etc； 2） specific symptoms， such as brain weight loss， P-tau immune-positive neurofibrillary tangles， TDK-43 positive neurite， astrocytic hyperplasia， and such， were found in CTE pathological analysis； 3） sport related mild brain injury and CTE staging， classification and diagnosis standards had been put forward， but they still need to be supported by a lot of experiments； 4） in terms of neuroimaging science， mainly such techniques as DTI， fMRI and SWI were used to diagnose athlete patients； 5） current researches were mainly retrospective researches on athlete patients； related researches need to do more forward-looking work in order to make breakthroughs. To establish ideal animal models， to develop specific biomarkers， and such， are main ways to resolve current research bottleneck， and research on athlete CTE risk