脑小血管疾病病理机制的研究进展  

Research progress on pathological mechanism of cerebral small vessel disease

作　　者：耿晔 吕建萌[2] 雷琦[2] 杨谦[2] GENG Ye;LYU Jianmeng;LEI Qi;YANG Qian(Xi’an Medical University,Xi’an 710021,China;Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]西安医学院,陕西西安710021 [2]陕西省人民医院,陕西西安710068

出　　处：《中国实用神经疾病杂志》2021年第4期363-368,共6页Chinese Journal of Practical Nervous Diseases

基　　金：陕西省重点研发计划项目(编号:2017SF-289)。

摘　　要：在过去十年中全球预期寿命大幅增加,与年龄相关性疾病对社会和卫生保健系统造成的挑战愈演愈烈。脑小血管疾病(cerebral small vessel disease,CSVD)是一种增龄性脑微血管病变,其患病率随年龄增长而增加,在50~90岁人群中患病率由5%升至几乎100%,是导致卒中和血管性痴呆的重要血管因素,并与步态障碍和情绪障碍有关。研究表明全球约50%的痴呆症及25%的卒中与CSVD相关,且近年来CSVD的发病率逐年递增并呈多样化,关注CSVD、保护大脑健康成为重中之重。但其潜在的发病机制尚未明确,目前认为CSVD的最关键病理生理机制之一是内皮功能障碍和血脑屏障(BBB)渗漏。本文回顾了CSVD病理学相关文献,并按照CSVD的影像学标志物类型对其病理特征进行综述,其中特别强调了内皮功能障碍在初始发病机制中的作用,以期帮助确定干预的潜在目标,提高小血管疾病患者的风险预测。Over the past decade,global life expectancy has increased significantly,and the challenges posed by age-related diseases to society and health care systems have intensified.Cerebral small vessel disease(CSVD)is a kind of aging cerebral microvascular disease,and its prevalence rate increases with age.in people aged 50 to 90 years old,the prevalence rate increases from 5%to almost 100%.It is an important vascular factor leading to stroke and vascular dementia,and is related to gait and mood disorders.Studies have shown that about 50%of dementia and 25%of strokes worldwide are associated with CSVD,and in recent years,the incidence of CSVD is increasing year by year and diversified,so it is a top priority to pay attention to the protection of brain health by CSVD.However,the potential pathogenesis of CSVD is not clear.At present,it is considered that one of the most critical pathophysiological mechanisms of CSVD is endothelial dysfunction and blood-brain barrier(BBB)leakage.Therefore,this paper reviews the relevant literature on pathology of CSVD and reviews its pathological features according to the types of imaging markers of CSVD,with special emphasis on the role of endothelial dysfunction in the initial pathogenesis,in order to help determine the potential target of intervention.Improve the risk prediction of patients with small vessel disease.

关 键 词：脑小血管疾病 内皮功能障碍 血脑屏障渗漏 病理机制 

分 类 号：R743[医药卫生—神经病学与精神病学]