中国卒中杂志 ›› 2017, Vol. 12 ›› Issue (02): 132-142.DOI: 10.3969/j.issn.1673-5765.2017.02.007

• 专题综述 • 上一篇    下一篇

脑小血管病和脑微循环研究进展

刘品一,黄丽丽,徐运   

  1. 210008 南京南京医科大学鼓楼临床学院神经科
  • 收稿日期:2016-11-07 出版日期:2017-02-20 发布日期:2017-02-20
  • 通讯作者: 徐运 xuyun20042001@aliyun.com
  • 基金资助:

    江苏省科技厅医学重点项目(2016610)

Progress in Research of Cerebral Small Vessel Disease and Cerebral Microcirculation

  • Received:2016-11-07 Online:2017-02-20 Published:2017-02-20

摘要:

脑小血管病(cerebral s mall v essel d isease, C SVD)指由脑微循环(包括脑小血管或微血管) 的病理变化而引起的急性卒中、认知功能障碍等多种临床表现。脑微循环的动脉粥样硬化与栓塞、 内皮功能障碍与血脑屏障破坏、淀粉样蛋白沉积、血流低灌注及静脉胶原性疾病与其发病机制密切 相关,并为其治疗提供了新的策略。脑小血管病的明确诊断依赖组织活检,但此时常常是疾病的终末 期,且组织病理难以获得,故临床上主要依靠神经影像学来获得诊断。本文就脑小血管病的临床表 现、分类、微循环相关性病理生理机制及临床微循环检查方法进行阐述,以期寻找脑小血管病新的 诊断与治疗策略。

文章导读: 脑微循环障碍与脑小血管病的发病机制密切相关,关于脑微循环的研究将为脑小血管病的诊疗提供新的策略。

关键词: 脑小血管病; 脑微循环; 血脑屏障; 病理生理

Abstract:

Cerebral small vessel disease (CSVD) refers to a syndrome caused by pathophysiologic changes of cerebral microcirculation (including cerebral small vessels or the microvessels) and it can result in acute stroke, cognitive impairment, and many other clinical manifestations. Arteriolosclerosis, embolism, endothelial dysfunction, blood-brain barrier damage, amyloid deposition, cerebral hypoperfusion and venous collagenosis of cerebral microcirculation are thought to be closely associated with the pathogenesis of CSVD, which provide new strategies for its treatment. A definite diagnosis of this disease relies on biopsy, which usually indicates that it is the end stage of the disease. Also, it is difficult to obtain histopathologic materials, so clinical diagnosis is mainly dependent on neuroimaging. This review discusses the manifestations, classification, pathophysiologic mechanisms and clinical examinations related to cerebral microcirculation, so as to find new diagnostic and therapeutic strategies for cerebral small vessel disease.

Key words: Cerebral small vessel disease; Cerebral microcirculation; Blood-brain barrier; Pathophysiology