创伤性脑损伤患者应激障碍发病机制及治疗方法的研究进展  

Research progress in pathogenesis and treatment of post-traumatic stress disorder in patients with traumatic brain injury

作　　者：叶益超 郭彦谷 史汉童 侯晓翔 张丹枫 侯立军 Ye Yichao;Guo Yangu;Shi Hantong;Hou Xiaoxiang;Zhang Danfeng;Hou Lijun(Department of Neurosurgery,Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;Unit 31639 of PLA,Chongzuo 530000,China)

机构地区：[1]海军军医大学第二附属医院神经外科,上海200003 [2]中国人民解放军31639部队,崇左530000

出　　处：《中华创伤杂志》2023年第10期947-953,共7页Chinese Journal of Trauma

基　　金：国家自然科学基金(82271396);军队后勤科研重点项目(BHJ22J019);上海市医学创新研究专项(21Y21900400)。

摘　　要：创伤后应激障碍(PTSD)是患者身体或情感遭受创伤事件后最普遍的精神疾病, 可出现持续的强烈、痛苦、害怕回避的反应及情绪和认知改变, 给患者心理上造成沉重的刺激和负担, 甚至导致一些过激的行为反应出现。创伤性脑损伤(TBI)是发生PTSD的重要因素, 两者有较多相似的病理重叠, 且可能共存和相互作用。其中, 海马体和杏仁核在PTSD的发病机制中起到核心作用, 但其具体的细胞分子和神经环路机制仍不明确。而当前治疗方法繁杂且未统一, 心理治疗后约有2/3的患者仍符合PTSD的诊断标准;经药物治疗的患者可能出现药物不良反应、治疗效果不佳及病情复发。因此, 进一步明确TBI患者PTSD的发生及发展过程具有重要的意义。笔者就TBI患者PTSD发病机制及治疗方法的研究进展进行综述, 为TBI患者PTSD相关研究及其治疗提供参考。Posttraumatic stress disorder(PTSD),the most common mental illness after patients suffer physically or emotionally from traumatic events,can cause persistently strong,painful and terrible avoidance symptoms,emotional and cognitive changes,causing psychologically strong stimulation and heavy burden to patients and even leading to some extreme behavioral reactions.Traumatic brain injury(TBI)is an important factor in the occurrence of PTSD,both of which shares many similar pathological overlaps,and may coexist and interact with each other.The hippocampus and amygdala play a central role in the pathogenesis of PTSD,but the specific cellular and molecular and neural circuit mechanisms are still unclear.About two-thirds of the patients still meet the diagnostic criteria for PTSD after psychotherapy.However,the current treatment methods are complicated and not unified,and patients treated with medications may have adverse drug reactions,poor treatment outcomes and recurrence.Therefore,it is of great significance to further clarify the occurrence and development of PTSD in TBI patients.The authors reviewed the research progress of the pathogenesis and treatment of PTSD in TBI patients,so as to provide reference for the related research and treatment of PTSD in TBI patients.

关 键 词：脑损伤 创伤性 应激障碍 创伤后 综合治疗 发病机制 

分 类 号：R651.15[医药卫生—外科学]