增龄相关性脑小血管病治疗新进展

doi:10.3969/j.issn.1673-5765.2020.04.008

摘要/Abstract

摘要：

随着全球预期寿命的延长，增龄相关性脑小血管病（cerebral small vessel disease，CSVD）患病率不断增加。最近研究显示，深穿支动脉病（deep perforating arteriopathy，DPA）和脑淀粉样血管病（cerebral amyloid angiopathy，CAA）均属于增龄相关性脑小血管病谱系（spectrum of age-related cerebral small vessel diseases）疾病，两者存在重叠性，且相互作用。增龄相关性CSVD治疗包括特异性及非特异性治疗。非特异性治疗包括控制血管危险因素、抗血小板治疗及静脉溶栓等。特异性治疗方面，最近研究提示抗炎治疗对增龄相关性CSVD或许有效；而针对CAA相关性炎症，已显示其对类固醇和（或）环磷酰胺有良好的反应。随着对增龄相关性CSVD发病机制的进一步了解，未来可能会出现更多特异性的治疗方法。

文章导读： 增龄相关性CSVD目前主要是防治血管危险因素、抗血小板及溶栓治疗，抗炎治疗尚缺乏有效的临床证据。

关键词: 脑小血管病; 深穿支动脉病; 脑淀粉样血管病; 老龄化

Abstract:

With the increase of life expectancy worldwide, the prevalence of age-related cerebral small vessel diseases (CSVD) is increasing. Recent studies have shown that deep perforating arteriopathy (DPA) and cerebral amyloid angiopathy (CAA) belong to the spectrum of age-related cerebral small vessel diseases, which overlap and interact with each other. Treatment of age-related CSVD includes specific and non-specific treatment. Non-specific treatment includes controlling vascular risk factors, antiplatelet therapy, intravenous thrombolysis and etc. For specific treatment, recent studies showed that anti-inflammatory therapy may be effective for age-related CSVD, and CAA-related inflammation responds well to corticosteroids and/or cyclophosphamide. With further understanding of the pathogenesis of age-related CSVD, more specific therapies maybe emerge.

Key words: Cerebral small vessel disease; Deep perforating arteriopathy; Cerebral amyloid angiopathy; Aging

陆正齐，李铁梅. 增龄相关性脑小血管病治疗新进展[J]. 中国卒中杂志, 2020, 15(04): 371-375.

LU Zheng-Qi, LI Tie-Mei. Progress in Treatment of Age-related Cerebral Small Vessel Diseases[J]. Chinese Journal of Stroke, 2020, 15(04): 371-375.

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