创伤性脑损伤(traumatic brain injury,TBI)已造成严重的经济和社会负担,但因其异质性的特点,尚未有有效的治疗方法。 在各种程度的颅脑损伤中,弥漫性轴索损伤(diffuse axonal injury,DAI)的发病率很高,对 DAI 的研究有助于 TBI 诊治。 本文对 TBI 的分类和 DAI 相关研究现状进行总结,对动物实验研究和临床中常用的脑损伤检测方法、动物实验模型及其相关损伤准则和阈值进行综述。 结果显示,DAI 主要由旋转加速度产生,与角加速度、角速度和持续时间相关。 已有众多动物模型能够产生 DAI 病理特征,且已有惯性旋转模型可以产生纯旋转加速度。然而,这些模型均为瞬时旋转模型,旋转时间并不严格可控,且不能够提供更长时间的旋转时间,从而不能研究长时间旋转运动下的 DAI 程度。 本文建议,可开发时间可控的旋转脑损伤模型,用以确定长时间和短时间旋转加速度下的脑损伤阈值,并探究这些致伤条件下的病理机制。 这些研究可能对 DAI 的预防和治疗起到积极作用。
Traumatic brain injury ( TBI ) has caused serious economic and social burdens, but due to its heterogeneity, there is no effective treatment. In TBI with different severity, diffuse axonal injury (DAI) incidenceis high. The investigation on DAI will contribute to the diagnosis and treatment of TBI. In this study, the classification of TBI and the research status of DAI were summarized. The method to judge the severity of TBI and DAI, and animal experimental models and related injury criteria and thresholds were reviewed. The result show that DAI is mainly generated by rotational acceleration and it is related to angular acceleration, angular velocity and duration. Several TBI animal models can induce the pathology of DAI, and inertial rotation models which can produce only rotational acceleration have been developed. However, these models are instantaneous rotation models, and the rotation duration is uncontrollable, thus a longer duration is impossible, and DAI severity under long rotational motion cannot be studied. The study proposes that a new rotation animal model which can control rotation duration should be developed. The development of the animal model and investigation on pathomechanism of the model will contribute to the prevention and treatment of DAI.
王丽珍,殷 欢,徐 鹏,樊瑜波.旋转运动下脑组织致伤机制研究[J].医用生物力学,2023,38(1):14-29复制