中国卒中杂志 ›› 2017, Vol. 12 ›› Issue (06): 554-558.DOI: 10.3969/j.issn.1673-5765.2017.06.017

• 综述 • 上一篇    下一篇

症状性颅内动脉粥样硬化斑块的致病机制研究进展

李韶雅,李敬伟,徐运   

  1. 210008 南京南京大学医学院附属鼓楼医院神经内科
  • 收稿日期:2016-07-11 出版日期:2017-06-20 发布日期:2017-06-20
  • 通讯作者: 李敬伟 ljw323@yeah.net
  • 基金资助:

    国家自然科学基金青年项目(81200896)
    国家自然科学基金(81571134)
    江苏省六大人才高峰D类资助项目(2015-WSN-084)
    江苏省博士后科研资助计划(1501077A)

Study Advances in Pathogenesis of Symptomatic Intracranial Atherosclerotic Plaques

  • Received:2016-07-11 Online:2017-06-20 Published:2017-06-20

摘要:

卒中是我国人口死亡和致残的第一位原因,其中急性缺血性卒中占高达60%~80%。动脉 粥样硬化造成的血管狭窄是缺血性卒中的重要原因。在我国,颅内动脉狭窄较颅外动脉狭窄多见,大 脑中动脉、基底动脉等最易受累。但人们往往过多地在意血管狭窄程度致脑缺血的作用,而忽略了 其他多种因素的作用,如斑块性质、斑块位置、侧支循环状况及血流动力学异常等。很多研究者认为, 斑块的不稳定性可能比狭窄率更重要。也有研究者认为,血流动力学的改变是导致急性缺血性卒中 发生的重要原因。本文将对这些致病机制的最新进展进行综述,希望可以加深对脑血管疾病的认识 和理解,进一步指导治疗。

文章导读: 本文综述了颅内动脉粥样硬化斑块的致病机制研究进展,旨在加深和全面理解其致病机制,提供个体化治疗依据。

关键词: 缺血性卒中; 颅内动脉硬化; 易损斑块; 侧支循环; 血流动力学异常

Abstract:

Stroke has become the first cause of death and disability in China, in which acute ischemic stroke accounts for 60%-80%. Vascular stenosis caused by atherosclerosis (AS) is an important cause of ischemic stroke. For the Chinese people, intracranial atherosclerotic stenosis is more common, and the most common stenotic vessels are middle cerebral artery and basilar artery. In the past, researchers tended to pay too much attention to the artery stenosis that caused ischemic stroke, and neglected the role of many other factors, such as characteristics of plaque, plaque location, collateral circulation status and hemodynamic abnormalities, etc. Many researchers believed that the plaque instability might be more important than the extent of stenosis. Many other researchers claimed that the change of hemodynamics was an important cause of acute ischemic stroke. This paper is to review the recent progress of these pathogenic mechanisms, aiming at deepening our acquaintance and comprehension of cerebral vascular disease, so as to provide further guidance in treatment.

Key words: Ischemic stroke; Intracranial atherosclerosis; Venerable plaque; Collateral circulation; Hemodynamics