颅脑爆震伤致认知功能障碍的分子机制研究进展  

Molecular mechanism of cognitive dysfunction caused by blast traumatic brain injury:a review

作　　者：李亮 王琪 范小琳 王鸿 李晓 喻伯牙 高俊宏 Li Liang;Wang Qi;Fan Xiaolin;Wang Hong;Li Xiao;Yu Boya;Gao Junhong(Institute for Hygiene of Ordnance Industry,Xi′an Key Laboratory of Toxicology and Biological Effect,Xi′an 710065,China)

机构地区：[1]兵器工业卫生研究所,西安市毒理与生物效应重点实验室,西安710065

出　　处：《中华创伤杂志》2024年第1期87-92,共6页Chinese Journal of Trauma

基　　金：陕西省自然科学基金(2023-JC-QN-0983,2023-JC-YB-684)。

摘　　要：颅脑爆震伤(bTBI)导致的认知功能障碍是一种严重的神经系统疾病,其发病率高、病情严重、预后差。bTBI会导致患者出现短期记忆丧失、注意力不集中或多任务处理困难等一系列症状,严重者发展为阿尔茨海默病,对其正常工作生活产生极大的影响。目前,关于bTBI致认知功能障碍的研究主要涉及模型构建、发病机制、病理生理改变、诊断治疗等方面,但关于其发生的分子机制还有待进一步研究。正常生理状态下,兴奋性和抑制性神经递质释放、Ca2+的释放与摄取、氧化和抗氧化系统、凋亡的促进和抑制处于动态平衡,bTBI使这种平衡状态发生紊乱,将从分子水平上导致神经细胞的损伤,进而造成认知功能障碍的发生。为此,笔者从兴奋性毒性与Ca2+稳态失调、氧化应激、炎症和水肿、细胞凋亡等方面,对bTBI致认知功能障碍分子机制的研究进展进行综述,为bTBI患者认知功能障碍的治疗和康复提供参考。Cognitive dysfunction caused by blast traumatic brain injury(bTBI)is a serious neurological disease with high incidence,serious condition and poor prognosis.bTBI can lead to a series of symptoms such as short-term memory loss,inattention or multi-tasking difficulties.In severe cases,bTBI can develop into Alzheimer′s disease,which has a great impact on patients′normal work and life.At present,researches on cognitive dysfunction caused by bTBI mainly involve model construction,pathogenesis,pathophysiological changes,diagnosis and treatment,etc.,and the molecular mechanism of its occurrence remains to be further studied.Under normal physiological conditions,the release of excitatory and inhibitory neurotransmitters,the release and uptake of Ca2+,oxidation and antioxidant systems,and the promotion and inhibition of apoptosis are in a dynamic balance.bTBI disturbs the balance,which will lead to the damage of nerve cells at the molecular level,thus resulting in the occurrence of cognitive dysfunction.To this end,the authors summarized the aspects of excitatory toxicity and Ca2+homeostasis disorder,oxidative stress,inflammation and edema,apoptosis,etc.,and reviewed the research progress on the molecular mechanism of cognitive dysfunction caused by bTBI,so as to provide a reference for the treatment and rehabilitation of cognitive dysfunction in patients with bTBI.

关 键 词：颅脑损伤 爆震伤 认知障碍 分子机制 

分 类 号：R651.15[医药卫生—外科学] R749.1[医药卫生—临床医学]