由中华神经科杂志相关文献总结中国内地临床神经病理的发展与成就

Developments and achievements of the clinical neuropathology in China from 1955 to 2009 ： based on survey of literatures related pathology published in Chinese Journal of Neurology

目的认识中国内地55年来临床神经病理领域的发展与成就。方法回顾性查阅中华神经科杂志自1955年创刊至2009年12月期间与临床神经病理相关的文献；统计不同时期神经疾病及临床神经病理文献总数，并计算临床神经病理文献所占百分比；统计不同时期尸检与活体组织检查病理文献比例；统计各时期神经病理文献前5位疾病类型；并与JNNP（JNeurolNeurosurgPsychiatry）同期相关文献进行比较。结果（1）1955-1959年、1960-1969年、1970-1979年、1980-1989年、1990-1999年、2000-2009年临床神经病理文献占同期中华神经科杂志文献总数百分比分别为18．11％（65／359）、20．81％（103／495）、17．05％（22／129）、15．50％（230／1484）、11．58％（176／1520）、16．04％（309／1927），其变化趋势差异有统计学意义（趋势x^2=7．977，P=0．005）；但与，JNNP同期临床神经病理文献百分比变化趋势相比差异无统计学意义。（2）1955-2009年不同时期尸检病理文献占同期临床神经病理文献总数的百分比呈逐渐下降趋势；1980-2009年中华神经科杂志刊载的尸检神经病理文献的百分比较JNNP逐渐减少，变化趋势差异有统计学意义。（3）不同时期神经病理文献中排前的疾病类型是：1955-1989年为肿瘤、感染性疾病及脑血管病；1990-2009年肌肉疾病则成为神经病理文献的主要疾病类型；与，JNNP刊载的临床神经病理文献比较，中华神经科杂志刊载的疑难罕见疾病和神经变性疾病的临床病理文献相对较少。结论神经病理研究在临床神经科学中占有重要地位，中国内地临床神经病理的主要发展成就在于对肿瘤、脑血管病、感染性疾病以及肌病等常见疾病有了较深入地研究与认识。但近年来尸检病理的匮乏制约了我们对神经变性疾病和一些疑难罕见神经疾病的深入研究与认识。

Objective To recognize the developments and achievements of the clinical neuropathology in China from 1955 to 2009. Methods Retrospective survey of literatures related clinical neuropathology published in Chinese Journal of Neurology （CJN） from the first issue in 1955 to the No. 12 issue in 2009 was conducted; Total literatures of CJN and literatures of the clinical neuropathology were respectively counted and the percentage of the latter was analyzed in different periods ; Proportion of autopsy and biopsy literatures was also analyzed. According to categories of nervous system diseases, their relative percentages were respectively counted. The percentages of clinical neuropathologieal literatures and autopsy literatures of CJN were compared with the data of the same period of J Neurol Neurosurg Psychiatry （JNNP）. Results （ 1 ） The percentages of clinical neuropathologieal literatures in total literatures of CJN were 18.11% （65/359）, 20. 81% （103/495）, 17.05% （22/129）, 15.50% （230/1484）, 11.58% （176/1520） and 16. 04% （309/1927）, respectively, in 1955-1959, 1960-1969, 1970-1979, 1980- 1989, 1990-1999, 2000-2009. The percentage variation trend in different periods from 1955 to 2009 had significant difference （ trend X2 = 7. 977, P = 0. 005 ） ; But there was no significant difference in the variation trend of the percentage of clinical neuropathological literatures between CJN and JNNP from 1955 to 2009.（2） The percentages of autopsy in the total clinical neuropathological literatures of CJN from 1995 to 2009 appeared gradually to decline; Compared with JNNP, the percentages of autopsy in the total clinical neuropathological literatures of CJN during 1980--2009 were lower, and there was significant difference in the variation trend of the percentage of autopsy in the total clinical neuropathological literatures between CJN and JNNP. （3） The main types of neurological diseases in the neuropathological literatures were tumors, infectious diseases and cerebrovascular diseases from 1955 to 1989, while myopathies became the most main disease type during 1990--2009; Compared with the same period JNNP, the clinical neuropathological literatures of the rare and difficult diseases and neurodegenerative diseases in CJN were relatively less. Conclusions Neuropathology is important in the clinical neuroscience research. From 1955 to 2009, main achievements of clinical neuropathological researches in China mainland lie in tumors, cerebrovascular diseases, infectious diseases and myopathies. But in recent years, due to the lack of autopsy cases, it is to the disadvantage of exploring pathogenesis of neurodegenerative diseases and understanding some rare and difficult diseases.