年轻运动员运动中猝死的常见原因是什么？赛前筛查有用吗？
What usually causes sudden death in young athletes during sport, and does pre-participation screening help?
在青年运动员中，猝死多因潜在的结构性或电生理性心脏病在剧烈运动时诱发恶性室性心律失常，常见病因包括肥厚型心肌病、冠状动脉起源异常、心肌炎、致心律失常性心肌病和长QT等离子通道病。赛前病史问诊加体格检查可发现部分线索，加做心电图能提高对肥厚型心肌病、长QT等的检出率，但假阳性率、成本效益和取消参赛的代价仍有争议。现场配备自动体外除颤器并及时开始心肺复苏对生存率的改善已被反复证实。
In young athletes, sudden death usually reflects an underlying structural or electrical heart disease that triggers malignant ventricular arrhythmia during intense exertion, most often hypertrophic cardiomyopathy, anomalous coronary artery origin, myocarditis, arrhythmogenic cardiomyopathy or channelopathies such as long QT syndrome. History and physical examination detect some cases, and adding an ECG improves detection of conditions like hypertrophic cardiomyopathy and long QT, though false positives, cost-effectiveness and the consequences of disqualification remain debated. What is repeatedly confirmed is that on-site automated external defibrillators and prompt cardiopulmonary resuscitation improve survival.
难度 专业 · 适合 高中(15-18)
CC BY 4.0 · 来源待核验 · Source pending review结论有争议 · Contested
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出处备注：著录含书名，但缺版次 / 出版社 / 年份中的一部分，需编辑补全后才能做独立比对。
《新英格兰医学杂志》(NEJM)（Maron，年轻运动员猝死综述，2003）
NEJM (Maron, sudden death in young athletes, 2003)
#运动性猝死 #肥厚型心肌病 #赛前筛查
什么是运动诱发的支气管收缩？
What is exercise-induced bronchoconstriction?
剧烈运动时通气量大增，大量干冷空气快速通过气道使黏膜水分蒸发、局部渗透压升高，刺激肥大细胞等释放炎症介质，引起气道平滑肌收缩。典型表现是运动开始后5～15分钟出现咳嗽、胸闷、气短，休息后逐渐缓解。它常见于哮喘患者，但也可单独存在，尤其在寒冷干燥环境或高强度耐力项目中。对策包括充分热身、用鼻或围巾预暖空气、按医嘱在运动前使用短效β2受体激动剂，并把基础哮喘控制好；游泳等温暖湿润环境的项目通常更易耐受。
During vigorous exercise ventilation soars, and large volumes of dry cold air rushing through the airways evaporate mucosal water and raise local osmolality, prompting mast cells and others to release inflammatory mediators that constrict airway smooth muscle. Typically cough, chest tightness and breathlessness appear five to fifteen minutes after exercise begins and ease with rest. It is common in asthma but can occur on its own, especially in cold dry conditions or high-intensity endurance sports. Management includes a thorough warm-up, pre-warming air by breathing through the nose or a scarf, using a short-acting beta-2 agonist before exercise as prescribed, and keeping any underlying asthma well controlled; warm humid settings such as swimming pools are usually better tolerated.
难度 专业 · 适合 高中(15-18)
CC BY 4.0 · 已核验 · Verified 2026-08-23 · 2 条独立证据
来源 · Source
Harrison's Principles of Internal Medicine 第20版,McGraw-Hill,2018
J. Loscalzo et al., Harrison's Principles of Internal Medicine, 20th ed., McGraw-Hill, 2018
独立核验依据 · Independent verification: 核验依据 2 OPENLIBRARY ISBN 标识 9781259644047（按标识回读: Harrison's prin
#运动性支气管收缩 #干冷空气 #哮喘 #运动前用药
慢性疼痛中的「中枢敏化」是怎么产生的？
How does central sensitisation develop in chronic pain?
持续的外周痛觉传入使脊髓背角神经元发生突触可塑性改变，NMDA受体活化、胶质细胞参与释放炎性介质，加上脑干下行抑制通路减弱，共同放大痛觉信号，表现为痛阈下降、轻触即痛以及疼痛范围超出原发损伤部位。此时疼痛更多来自神经系统处理方式的改变，而不能简单等同于组织仍在持续损伤，这类疼痛被归为痛觉调节异常型。因此治疗更强调渐进运动疗法、疼痛神经科学教育、改善睡眠和心理干预，并谨慎使用阿片类药物。
Sustained nociceptive input drives synaptic plasticity in dorsal horn neurons, with NMDA receptor activation and glial release of inflammatory mediators, while descending inhibitory pathways from the brainstem weaken, together amplifying pain signalling so thresholds fall, light touch hurts and pain spreads beyond the original injury site. Pain then reflects altered nervous system processing rather than ongoing tissue damage, and such presentations are classified as nociplastic pain. Treatment therefore emphasises graded exercise, pain neuroscience education, sleep and psychological interventions, with caution about opioids.
难度 专业 · 适合 高中(15-18)
CC BY 4.0 · 已核验 · Verified 2026-11-04
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Fitzcharles, Cohen, Clauw 与 Littlejohn,《Nociplastic pain: towards an understanding of prevalent pain conditions》,The Lancet,2021 (DOI: 10.1016/s0140-6736(21)00392-5)
Fitzcharles, Cohen, Clauw and Littlejohn, 'Nociplastic pain: towards an understanding of prevalent pain conditions', The Lancet, 2021, DOI: 10.1016/s0140-6736(21)00392-5
独立核验依据 · Independent verification: 核验依据 1 Crossref DOI 10.1016/s0140-6736(21)00392-5
#中枢敏化 #痛觉调节异常 #下行抑制
慢性腰痛为什么不建议长期卧床休息？
Why is prolonged bed rest not advised for chronic low back pain?
大规模证据综述指出，长期卧床会导致核心肌力下降、关节僵硬、疼痛敏化以及对活动的恐惧回避，反而延长病程和失能时间。多数非特异性腰痛并无严重结构性病变，一线处理是保持适度活动、运动疗法，并配合疼痛教育和必要的心理干预，常规影像检查和阿片类药物并不推荐。若出现下肢进行性无力、鞍区麻木、大小便失禁、发热或不明原因体重下降等危险信号，应及时就医。
Large evidence reviews show that prolonged bed rest weakens trunk muscles, stiffens joints, sensitises pain pathways and fosters fear-avoidance of movement, which lengthens the episode and increases disability. Most non-specific low back pain involves no serious structural lesion, and first-line care is staying reasonably active with exercise therapy plus pain education and psychological support when needed, while routine imaging and opioids are not recommended. Warning signs such as progressive leg weakness, saddle numbness, loss of bladder or bowel control, fever or unexplained weight loss warrant prompt medical assessment.
难度 进阶 · 适合 大众
CC BY 4.0 · 来源待核验 · Source pending review
来源 · Source
出处备注：此条未指向带版次的可引用著作（通识性内容、机构文件或未展开的英文书名），本库不提供独立书目出处；如需精确引用，需由编辑补全具体篇目与版次。
The Lancet（低背痛系列研究，2018）
The Lancet (Low Back Pain Series, 2018)
#慢性腰痛 #运动疗法 #恐惧回避
急性运动损伤还要按传统「RICE」原则一直冰敷吗？
Should acute sports injuries still be iced according to the traditional RICE approach?
近年运动医学建议把RICE更新为强调早期保护、避免过度抗炎、循序渐进恢复负荷的框架，例如PEACE与LOVE原则。冰敷可短期缓解疼痛，但目前没有证据表明它能加速组织愈合，长时间冰敷和大量使用非甾体抗炎药还可能干扰修复所需的正常炎症阶段。一般建议早期以保护、适度加压和抬高为主，症状允许后尽早开始渐进活动；若出现明显畸形、无法负重或肿痛持续加重，应就诊排除骨折等严重损伤。
Sports medicine guidance has updated RICE towards frameworks that stress early protection, avoiding excessive anti-inflammatory measures and gradually restoring load, such as the PEACE and LOVE principles. Ice can relieve pain briefly, but there is no good evidence that it speeds tissue healing, and prolonged icing or heavy use of non-steroidal anti-inflammatory drugs may interfere with the inflammatory phase that repair requires. It is generally advised to protect, apply moderate compression and elevate early, then begin graded movement as symptoms allow, and to seek assessment for possible fracture if there is obvious deformity, inability to bear weight or worsening swelling and pain.
难度 进阶 · 适合 初中(12-15)
CC BY 4.0 · 已核验 · Verified 2026-11-04
来源 · Source
Dubois, Esculier,《Soft-tissue injuries simply need PEACE and LOVE》,British Journal of Sports Medicine,2020 (DOI: 10.1136/bjsports-2019-101253)
Dubois, Esculier, 'Soft-tissue injuries simply need PEACE and LOVE', British Journal of Sports Medicine, 2020, DOI: 10.1136/bjsports-2019-101253
独立核验依据 · Independent verification: 核验依据 1 Crossref DOI 10.1136/bjsports-2019-101253
#急性损伤处理 #PEACE与LOVE #冰敷争议
前交叉韧带撕裂为什么很难自己长好？
Why does a torn anterior cruciate ligament heal so poorly on its own?
前交叉韧带位于关节腔内并被滑液包围，血供有限，断裂后缺乏形成愈合桥梁所需的血肿和纤维支架，断端还会回缩，因此完全撕裂通常不能自行连续愈合。膝关节随之失去前向和旋转稳定性，可能反复出现打软腿，并继发半月板和软骨损伤。随机试验显示部分患者经系统康复也能取得良好功能，是否重建应结合运动需求、不稳定程度和合并损伤共同决定。
The anterior cruciate ligament sits inside the joint cavity bathed in synovial fluid with limited blood supply, so after rupture it lacks the haematoma and fibrous bridge needed for healing and the torn ends retract, which means complete tears rarely reunite spontaneously. The knee then loses anterior and rotational stability, giving episodes of giving way and secondary meniscal and cartilage damage. Randomised trials show some patients do well with structured rehabilitation, so the decision to reconstruct should weigh activity demands, degree of instability and associated injuries.
难度 进阶 · 适合 初中(12-15)
CC BY 4.0 · 来源待核验 · Source pending review
来源 · Source
出处备注：著录含书名，但缺版次 / 出版社 / 年份中的一部分，需编辑补全后才能做独立比对。
《新英格兰医学杂志》(NEJM)（Frobell 等，急性前交叉韧带撕裂治疗随机试验，2010）
NEJM (Frobell et al., randomised trial of treatment for acute ACL tears, 2010)
#前交叉韧带 #关节内韧带愈合 #膝关节稳定性
运动时小腿抽筋是因为缺钙吗？
Are exercise cramps caused by a lack of calcium?
多数运动相关性抽筋并非缺钙。目前证据更支持“神经肌肉疲劳”假说：肌肉过度疲劳后，来自肌腱的抑制性反馈减弱、来自肌梭的兴奋性输入增强，脊髓运动神经元异常放电，导致局部肌肉持续强烈收缩。现场处理是缓慢牵伸抽筋肌肉并轻柔按摩。大量出汗时补充含钠电解质饮料可能有帮助，训练循序渐进最有效；若休息时反复抽筋，应排查缺水、电解质紊乱、药物副作用、周围血管或神经疾病。
Most exercise-associated cramps are not about calcium. Current evidence favours the neuromuscular fatigue hypothesis: after heavy fatigue, inhibitory feedback from tendon receptors weakens while excitatory input from muscle spindles rises, so spinal motor neurons fire abnormally and the muscle contracts intensely and continuously. On the spot, slowly stretch the cramping muscle and massage it gently. Sodium-containing electrolyte drinks may help when sweating heavily, and progressive conditioning works best; frequent cramps at rest should prompt a check for dehydration, electrolyte disturbance, drug side effects, or vascular and nerve disorders.
难度 进阶 · 适合 大众
CC BY 4.0 · 已核验 · Verified 2026-08-23 · 2 条独立证据
来源 · Source
《默克家庭医学手册》Merck Manual Home Health Handbook 中译版,人民卫生出版社
The Merck Manual Home Health Handbook, Chinese ed., PMPH
独立核验依据 · Independent verification: 核验依据 2 DOUBAN ISBN 标识 9787117181631（按标识回读: 默克家庭医学手册）
#肌肉抽筋 #神经肌肉疲劳 #牵伸 #电解质
运动中的「相对能量不足」（RED-S）会带来什么问题？
What problems does relative energy deficiency in sport cause?
当训练消耗长期超过能量摄入、可用能量不足时，机体会下调非必需功能以节省能量，表现为女性月经紊乱或停经、男性睾酮下降，骨密度降低和应力性骨折风险增加，还可能影响免疫、心血管、胃肠功能、情绪和运动表现。它并非只见于精英女性运动员，男性和大众健身人群同样可能发生，尤其在刻意限制饮食或追求低体重的项目中。一般建议增加能量摄入、调整训练负荷，并由运动医学与营养专业人员共同评估处理。
When training expenditure chronically exceeds intake and energy availability falls too low, the body downregulates non-essential functions to save energy, producing menstrual disturbance or amenorrhoea in women and reduced testosterone in men, along with lower bone density and more stress fractures, and it can also impair immune, cardiovascular and gastrointestinal function, mood and performance. It is not confined to elite female athletes: men and recreational exercisers are affected too, especially in sports that encourage dietary restriction or low body weight. Management generally means increasing energy intake and adjusting training load with combined sports medicine and nutrition assessment.
难度 进阶 · 适合 大众
CC BY 4.0 · 来源待核验 · Source pending review
来源 · Source
出处备注：此条未指向带版次的可引用著作（通识性内容、机构文件或未展开的英文书名），本库不提供独立书目出处；如需精确引用，需由编辑补全具体篇目与版次。
国际奥委会（IOC 关于运动中相对能量不足 RED-S 的共识声明）
International Olympic Committee (IOC consensus statement on relative energy deficiency in sport)
#相对能量不足 #能量可用性 #应力性骨折
运动后第二天的肌肉酸痛是乳酸堆积造成的吗？
Is next-day muscle soreness after exercise caused by lactic acid build-up?
不是。乳酸在停止运动后一小时左右基本被代谢清除，而延迟性肌肉酸痛通常在运动后12至24小时出现、48小时前后达到高峰。它主要与离心收缩造成的肌纤维和结缔组织微损伤、随后的炎症反应以及局部痛觉敏化有关，因此在初次训练、突然增加负荷、下坡跑或大量退让性力量训练后更明显。逐步增加训练量、充分热身和轻度活动性恢复有助于减轻不适。
No. Lactate is largely cleared within about an hour of stopping exercise, whereas delayed-onset muscle soreness typically appears 12 to 24 hours afterwards and peaks around 48 hours. It arises mainly from microdamage to muscle fibres and connective tissue during eccentric contractions, the ensuing inflammatory response and local sensitisation of nociceptors, which is why it is worse after unfamiliar training, sudden load increases, downhill running or heavy eccentric work. Progressive loading, thorough warm-up and light active recovery help reduce the discomfort.
难度 进阶 · 适合 初中(12-15)
CC BY 4.0 · 已核验 · Verified 2026-10-03
来源 · Source
《生理学》（骨骼肌收缩与运动性肌肉损伤）
Physiology (skeletal muscle contraction and exercise-induced muscle damage)
#延迟性肌肉酸痛 #离心收缩 #运动恢复
跟腱、网球肘等肌腱病为什么常推荐离心训练？
Why is eccentric loading commonly recommended for tendinopathies such as Achilles tendon pain and tennis elbow?
肌腱病的病理并非单纯炎症，而是胶原排列紊乱、基质退变、细胞活性改变以及新生血管和神经形成的退行性过程，因此单靠休息和消炎药往往效果有限。渐进性机械负荷，尤其是离心训练，可刺激胶原重塑、提高肌腱刚度并降低疼痛敏感性，多项研究显示它能改善疼痛与功能评分。一般建议在专业人员指导下按疼痛可耐受范围逐步加载，疗程通常需要数月而非数周。
Tendinopathy is not simply inflammation but a degenerative process with disorganised collagen, matrix breakdown, altered cell activity and ingrowth of new vessels and nerves, so rest and anti-inflammatory drugs alone often help little. Progressive mechanical loading, particularly eccentric exercise, stimulates collagen remodelling, increases tendon stiffness and reduces pain sensitivity, and multiple studies show improvement in pain and function scores. It is generally advised to load gradually within tolerable pain under professional guidance, expecting a programme lasting months rather than weeks.
难度 进阶 · 适合 大众
CC BY 4.0 · 来源待核验 · Source pending review
来源 · Source
出处备注：此条未指向带版次的可引用著作（通识性内容、机构文件或未展开的英文书名），本库不提供独立书目出处；如需精确引用，需由编辑补全具体篇目与版次。
British Journal of Sports Medicine（肌腱病负荷管理与离心训练研究）
British Journal of Sports Medicine (research on load management and eccentric training in tendinopathy)
#肌腱病 #离心训练 #渐进负荷