中国卒中杂志 ›› 2017, Vol. 12 ›› Issue (02): 132-142.DOI: 10.3969/j.issn.1673-5765.2017.02.007
刘品一,黄丽丽,徐运
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)
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。
刘品一,黄丽丽,徐运. 脑小血管病和脑微循环研究进展[J]. 中国卒中杂志, 2017, 12(02): 132-142.
LIU Pin-Yi, HUANG Li-Li, XU Yun. Progress in Research of Cerebral Small Vessel Disease and Cerebral Microcirculation[J]. Chinese Journal of Stroke, 2017, 12(02): 132-142.
1 Pantoni L. Cerebral small vessel disease:frompathogenesis and clinical characteristics to therapeuticchallenges[J]. Lancet Neurol,2010,9:689-701.2 Wardlaw JM,Smith C,Dichgans M. Mechanisms ofsporadic cerebral small vessel disease:insights fromneuroimaging[J]. Lancet Neurol,2013,12:483-497.3 Joutel A,Faraci FM. Cerebral small vessel disease:insights and opportunities from mouse models ofcollagen IV-related small vessel disease and cerebralautosomal dominant arteriopathy with subcorticalinfarcts and leukoencephalopathy[J]. Stroke,2014,45:1215-1221.4 De Silva TM,Miller AA. Cerebral small vesseldisease:target ing oxidative st ress as a noveltherapeutic strategy?[J]. Front Pharmacol,2016,7:61.5 Hachinski V. World Stroke Day 2008:"little strokes,big trouble"[J]. Stroke,2008,39:2407-2420.6 Thompson CS,Hakim AM. Living beyond ourphysiological means:small vessel disease of the brainis an expression of a systemic failure in arteriolarfunction:a unifying hypothesis[J]. Stroke,2009,40:e322-330.7 Craggs LJ,Yamamoto Y,Deramecourt V,et al.Microvascular pathology and morphometrics ofsporadic and hereditary small vessel diseases of thebrain[J]. Brain Pathol,2014,24:495-509.8 LADIS Study Group. 2001-2011:adecade of theLADIS (Leukoaraiosis And DISability) Study:whathave we learned about white matter changes andsmall-vessel disease?[J]. Cerebrovasc Dis,2011,32:577-588.9 Attwell D,Buchan AM,Charpak S,et al. Glial andneuronal control of brain blood flow[J]. Nature,2010,468:232-243.10 De Silva TM,Faraci FM. Microvascular dysfunctionand cognitive impairment[J]. Cell Mol Neurobiol,2016,36:241-258.11 Fisher CM. Lacunes:small,deep cerebral infarcts[J].Neurology,1965,15:774-784.12 Fisher CM. Lacunar strokes and infarcts:a review[J].Neurology,1982,32:871-876.13 Fisher CM. Lacunar infarcts-a review[J]. CerebrovascDis,1991,1:311-320.14 Mead GE,Lewis SC,Wardlaw JM,et al. Severeipsilateral carotid stenosis and middle cerebralartery disease in lacunar ischaemic stroke:innocentbystanders?[J]. J Neurol,2002,249:266-271.15 J a c k s o n CA,Hut ch i son A,Den n is MS,e tal. Dif fer ing r isk factor prof iles of ischemicstroke subtypes:evidence for a distinct lacunararteriopathy?[J]. Stroke,2010,41:624-629.16 Potter GM,Doubal FN,Jackson CA,et al. Lack ofassociation of white matter lesions with ipsilateralcarotid artery stenosis[J]. Cerebrovasc Dis,2012,33:378-384.17 Macdonald RL,Kowalczuk A,Johns L. Emboli enterpenetrating arteries of monkey brain in relation totheir size[J]. Stroke,1995,26:1247-1250;discussion1250-1251.18 Bailey EL,McCulloch J,Sudlow C,et al. Potentialanimal models of lacunar stroke:a systematicreview[J]. Stroke,2009,40:e451-458.19 Pantoni L,Garcia JH,Gutierrez JA. Cerebral whitematter is highly vulnerable to ischemia[J]. Stroke,1996,27:1641-1646;discussion 1647.20 Petito CK,Olarte JP,Roberts B,et al. Selective glialvulnerability following transient global ischemia inrat brain[J]. J Neuropathol Exp Neurol,1998,57:231-238.21 Brun A,Englund E. A white matter disorder in中国卒中杂志 2017年2月 第12卷 第2期 139dementia of the Alzheimer type:a pathoanatomicalstudy[J]. Ann Neurol,1986,19:253-262.22 Millikan C,Futrell N. The fallacy of the lacunehypothesis[J]. Stroke,1990,21:1251-1257.23 Boiten J,Lodder J. Lacunar infarcts. Pathogenesisand validity of the clinical syndromes[J]. Stroke,1991,22:1374-1378.24 Lee HY,Oh BH. Aging and arterial stiffness[J]. Circ J,2010,74:2257-2262.25 Poels MM,Zaccai K,Verwoert GC,et al. Arterialstiffness and cerebral small vessel disease:theRotterdam Scan Study[J]. Stroke,2012,43:2637-2642.26 Caplan LR,Hennerici M. Impaired clearance ofemboli (washout) is an important link betweenhypoperfusion,embolism,and ischemic stroke[J].Arch Neurol,1998,55:1475-1482.27 Diehl RR. Cerebral autoregulation studies in clinicalpractice[J]. Eur J Ultrasound,2002,16:31-36.28 Silberberg DH,Manning MC,Schreiber AD. Tissueculture demyelination by normal human serum[J].Ann Neurol,1984,15:575-580.29 Lammie GA,Brannan F,Wardlaw JM. Incompletelacunar infarct ion (Type I b lacunes)[J]. ActaNeuropathol,1998,96:163-171.30 Schley D,Carare-Nnadi R,Please CP,e t a l.Mechanisms to explain the reverse perivasculartransport of solutes out of the brain[J]. J Theor Biol,2006,238:962-974.31 Weller RO,Djuanda E,Yow HY,et al. Lymphaticdrainage of the brain and the pathophysiology ofneurological disease[J]. Acta Neuropathol,2009,117:1-14.32 Wardlaw JM,Sandercock PA,Dennis MS,et al. Isbreakdown of the blood-brain barrier responsiblefor lacunar stroke,leukoaraiosis,and dementia?[J].Stroke,2003,34:806-812.33 Ha i n swo r t h AH,Oommen AT,Br id ge s LR.Endothelial cells and human cerebral small vesseldisease[J]. Brain Pathol,2015,25:44-50.34 Wardlaw JM,Doubal F,Armitage P,et al. Lacunarstroke is associated with diffuse blood-brain barrierdysfunction[J]. Ann Neurol,2009,65:194-202.35 Topakian R,Barrick TR,Howe FA,et al. Bloodbrainbarrier permeability is increased in normalappearingwhite matter in patients with lacunar strokeand leucoaraiosis[J]. J Neurol Neurosurg Psychiatry,2010,81:192-197.36 Tomimoto H,Akiguchi I,Suenaga T,e t a l .Alterations of the blood-brain barrier and glialcells in white-matter lesions in cerebrovascular andAlzheimer's disease patients[J]. Stroke,1996,27:2069-2074.37 Utter S,Tamboli IY,Walter J,et al. Cerebral smallvessel disease-induced apolipoprotein E leakageis associated with Alzheimer disease and theaccumulation of amyloid beta-protein in perivascularastrocytes[J]. J Neuropathol Exp Neurol,2008,67:842-856.38 Young VG,Halliday GM,Kril JJ. Neuropathologiccor relates of white mat ter hyper intensities[J].Neurology,2008,71:804-811.39 Vigga r s AP,Whar ton SB,Simpson JE,et al.Alterations in the blood brain barrier in ageingcerebral cortex in relationship to Alzheimer-typepathology:a study in the MRC-CFAS populationneuropathology cohort[J]. Neurosci Lett,2011,505:25-30.40 Heye AK,Thrippleton MJ,Chappell FM,et al. Bloodpressure and sodium:Association with MRI markersin cerebral small vessel disease[J]. J Cereb BloodFlow Metab,2016,36:264-274.41 FredrikssonK,Nordborg C,Kalimo H,et al. Cerebralmicroangiopathy in stroke-prone spontaneouslyhypertensive rats. An immunohistochemical andultrastructural study[J]. Acta Neuropathol,1988,75:241-252.42 Lin JX,Tomimoto H,Akiguchi I,et al. White matterlesions and alteration of vascular cell compositionin the brain of spontaneously hypertensive rats[J].Neuroreport,2001,12:1835-1839.43 Ba i l e y EL,Wa r d l aw JM,Gr aham D,e t a l .Cerebral small vessel endothel ial st ructuralchanges predate hyper tension in st roke-pronespontaneously hypertensive rats:a blinded,controlledimmunohistochemical study of 5- to 21-week-oldrats[J]. Neuropathol Appl Neurobiol,2011,37:711-726.44 Ba i l e y EL,McBr ide MW,Beat t ie W,e t a l .Differential gene expression in multiple neurological,inflammatory and connective tissue pathways in aspontaneous model of human small vessel stroke[J].Neuropathol Appl Neurobiol,2014,40:855-872.45 Bragulat E,de la Sier ra A,Antonio MT,et al.Endothelial dysfunction in salt-sensitive essentialhypertension[J]. Hypertension,2001,37:444-448.46 Ma XJ,Cheng JW,Zhang J,et al. E-select indeficiency attenuates brain ischemia in mice[J]. CNSNeurosci Ther,2012,18:903-908.47 Rouhl RP,Damoiseaux JG,Lodder J,et al. Vascularinf lammation in cerebral small vessel disease[J].Neurobiol Aging,2012,33:1800-1806.140 Chin J Stroke, Feb 2017, Vol 12, No.248 Aribisala BS,Wiseman S,Morris Z,et al. Circulatinginflammatory markers are associated with magneticresonance imaging-visible perivascular spaces but notdirectly with white matter hyperintensities[J]. Stroke,2014,45:605-607.49 Abbott NJ. Inflammatory mediators and modulationof blood-brain barrier permeability[J]. Cell MolNeurobiol,2000,20:131-147.50 Leong XF,Ng CY,Badiah B,et al. Associationbetween hypertension and periodontitis:possiblemechanisms[J]. Scientific World Journal,2014,2014:768237.51 Nakano K,Hokamura K,Taniguchi N,et al. Thecollagen-binding protein of Streptococcus mutansis involved in haemorrhagic stroke[J]. Nat Commun,2011,2:485.52 Miya t a n i F,Kur iyama N,Wat anabe I,e t a l .Relationship between Cnm-positive Streptococcusmutans and cerebral microbleeds in humans[J]. OralDis,2015,21:886-893.53 Pussinen PJ,Alfthan G,Jousilahti P,et al. Systemicexposure to Porphyromonas gingivalis predictsincident stroke[J]. Atherosclerosis,2007,193:222-228.54 Lourbakos A,Yuan YP,Jenkins AL,et al. Activationof protease-activated receptors by gingipains fromPorphyromonas gingivalis leads to platelet aggregation:a new trait in microbial pathogenicity[J]. Blood,2001,97:3790-3797.55 Wa l t e r C,Za h l t e n J,S c hme c k B,e t a l .Porphyromonas gingivalis strain-dependent activationof human endothelial cells[J]. Infect Immun,2004,72:5910-5918.56 Ihara M,Yamamoto Y. Emerging evidence forpathogenesis of sporadic cerebral small vesseldisease[J]. Stroke,2016,47:554-560.57 Laurent S,Briet M,Boutouyrie P. Large and smallartery cross-talk and recent morbidity-mortality trialsin hypertension[J]. Hypertension,2009,54:388-392.58 S c u t e r i A,Ni l s son PM,Tz o u r io C,e t a l .Mic rovascular brain damage with aging andhypertension:pathophysiological consideration andclinical implications[J]. J Hypertens,2011,29:1469-1477.59 Bink DI,Ritz K,Aronica E,et al. Mouse models tostudy the effect of cardiovascular risk factors on brainstructure and cognition[J]. J Cereb Blood Flow Metab,2013,33:1666-1684.60 Hol land PR,Searcy JL,Salvadores N,et a l.Gliovascular disruption and cognitive deficits in amouse model with features of small vessel disease[J].J Cereb Blood Flow Metab,2015,35:1005-1014.61 Nakaji K,Ihara M,Takahashi C,et al. Matrixmetalloproteinase-2 plays a critical role in thepathogenesis of white matter lesions after chroniccerebral hypoperfusion in rodents[J]. Stroke,2006,37:2816-2823.62 Hat tor i Y,Okamoto Y,Maki T,et al. Si lentinformation regulator 2 homolog 1 counters cerebralhypoperfusion injury by deacetylating endothelialnitric oxide synthase[J]. Stroke,2014,45:3403-3411.63 F e n g S ,C e n J,Hu a n g Y,e t a l . M a t r i xmetalloproteinase-2 and -9 secreted by leukemic cellsincrease the permeability of blood-brain barrier bydisrupting tight junction proteins[J]. PLoS One,2011,6:e20599.64 Bailey EL,Smith C,Sudlow CL,et al. Is thespontaneously hyper tensive stroke prone rat apertinent model of sub cortical ischemic stroke? Asystematic review[J]. Int J Stroke,2011,6:434-444.65 Corbin ZA,Rost NS,Lorenzano S,et al. Whitematter hyperintensity volume correlates with matrixmetalloproteinase-2 in acute ischemic stroke[J]. JStroke Cerebrovasc Dis,2014,23:1300-1306.66 Ihara M,Tomimoto H. Lessons f rom a mousemodel characterizing features of vascular cognitiveimpairment with white matter changes[J]. J Aging Res,2011,2011:978 761.67 Armulik A,Abramsson A,Betsholtz C. Endothelial/pericyte interactions[J]. Circ Res,2005,97:512-523.68 Craggs LJ,Yamamoto Y,Ihara M,et al. Whitematter pathology and disconnection in the frontallobe in cerebral autosomal dominant arteriopathywith subcortical infarcts and leukoencephalopathy(CADASIL)[J]. Neuropathol Appl Neurobiol,2014,40:591-602.69 Cr aggs L J,Fe nwi ck R,Oa k ley AE,e t a l .Immunolocalization of platelet-derived growth factorreceptor-β (PDGFR-β) and pericytes in cerebralautosomal dominant arteriopathy with subcorticalinfarcts and leukoencephalopathy (CADASIL)[J].Neuropathol Appl Neurobiol,2015,41:557-570.70 Bell RD,Winkler EA,Sagare AP,et al. Pericytescontrol key neurovascular functions and neuronalphenotype in the adult brain and during brain aging[J].Neuron,2010,68:409-427.71 Miyamoto N,Maki T,Shindo A,et al. Astrocytespromote oligodendrogenesis after white matterdamage via brain-derived neurotrophic factor[J]. JNeurosci,2015,35:14 002-14 008.中国卒中杂志 2017年2月 第12卷 第2期 14172 Abbott NJ,Rönnbäck L,Hansson E. Astrocyteendothelialinteractions at the blood-brain barrier[J].Nat Rev Neurosci,2006,7:41-53.73 Maki T,Maeda M,Uemura M,et al. Potentialinteractions between pericytes and oligodendrocyteprecursor cells in perivascular regions of cerebralwhite matter[J]. Neurosci Lett,2015,597:164-169.74 Nakane H,Ibayashi S,Fujii K,et al. Cerebral bloodf low and metabolism in patients with silent braininfarction:occult misery perfusion in the cerebralcortex[J]. J Neurol Neurosurg Psychiatry,1998,65:317-321.75 Markus HS,Lythgoe DJ,Ostegaard L,et al. Reducedcerebral blood f low in white matter in ischaemicleukoaraiosis demonst rated using quantitativeexogenous contrast based perfusion MRI[J]. J NeurolNeurosurg Psychiatry,2000,69:48-53.76 Fu JH,Lu CZ,Hong Z,et al. Relationship betweencerebral vasomotor reactivity and white matter lesionsin elderly subjects without large artery occlusivedisease[J]. J Neuroimaging,2006,16:120-125.77 Shibata M,Ohtani R,Ihara M,et al. White matterlesions and glial activation in a novel mouse model ofchronic cerebral hypoperfusion[J]. Stroke,2004,35:2598-2603.78 Ba ck SA,Han BH,Luo NL,et al. Select ivevulnerability of late oligodendrocyte progenitors tohypoxia-ischemia[J]. J Neurosci,2002,22:455-463.79 Smith EE,Greenberg SM. Beta-amyloid,bloodvessels,and brain function[J]. Stroke,2009,40:2601-2606.80 Vinters HV. Cerebral amyloid angiopathy. A criticalreview[J]. Stroke,1987,18:311-324.81 Vonsattel JP,Myers RH,Hedley-Whyte ET,etal. Cerebral amyloid angiopathy without and withcerebral hemorrhages:a comparative histologicalstudy[J]. Ann Neurol,1991,30:637-649.82 Zekry D,Duyckaerts C,Belmin J,et al. Cerebralamyloid angiopathy in the elderly:vessel wallschanges and relationship with dementia[J]. ActaNeuropathol,2003,106:367-373.83 Smith EE,Gurol ME,Eng JA,et al. White matterlesions,cognition,and recurrent hemorrhage in lobarintracerebral hemorrhage[J]. Neurology,2004,63:1606-1612.84 Gurol ME,Irizarry MC,Smith EE,et al. Plasmabeta-amyloid and white matter lesions in AD,MCI,and cerebral amyloid angiopathy[J]. Neurology,2006,66:23-29.85 Holland CM,Smith EE,Csapo I,et al. Spatialdistribution of white-matter hyperintensities inAlzheimer disease,cerebral amyloid angiopathy,andhealthy aging[J]. Stroke,2008,39:1127-1133.86 Viswanathan A,Patel P,Rahman R,et al. Tissuemicrostructural changes are independently associatedwith cognitive impairment in cerebral amyloidangiopathy[J]. Stroke,2008,39:1988-1992.87 Viswanathan A,Greenberg SM. Cerebral amyloidangiopathy in the elderly[J]. Ann Neurol,2011,70:871-880.88 Kövari E,Charidimou A,Herrmann FR,et al. Noneuropathological evidence for a direct topographicalrelation between microbleeds and cerebral amyloidangiopathy[J]. Acta Neuropathol Commun,2015,3:49.89 Br own WR,Moody DM,Cha l la VR,e t a l .Venous collagenosis and arteriolar tortuosity inleukoaraiosis[J]. J Neurol Sci,2002,203-204:159-163.90 Zhou M,Mao L,Wang Y,et al. Morphologicchanges of cerebral veins in hypertensive rats:venouscollagenosis is associated with hypertension[J]. JStroke Cerebrovasc Dis,2015,24:530-536.91 Moody DM,Brown WR,Cha l la VR,e t a l .Periventricular venous collagenosis:association withleukoaraiosis[J]. Radiology,1995,194:469-476.92 Yan S,Wan J,Zhang X,et al. Increased visibilityof deep medullary veins in leukoaraiosis:a 3-T MRIstudy[J]. Front Aging Neurosci,2014,6:144.93 Pantoni L,Gorelick PB. Cerebral small vesseldisease[M]. Cambridge,United Kingdom:CambridgeUniversity Press,2014.94 van Golen LW,Kuijer JP,Huisman MC,et al.Quantification of cerebral blood f low in healthyvolunteers and type 1 diabetic patients:comparisonof MRI arterial spin labeling and [(15)O]H2O positronemission tomography (PET)[J]. J Magn ResonImaging,2014,40:1300-1309.95 Feng CM,Narayana S,Lancaster JL,et al. CBFchanges during brain activation:fMRI vs. PET[J].Neuroimage,2004,22:443-446.96 Wallin A,Blennow K,Fredman P,et al. Blood brainbarrier function in vascular dementia[J]. Acta NeurolScand,1990,81:318-322.97 Pantoni L,Inzitari D,Pracucci G,et al. Cerebrospinalfluid proteins in patients with leucoaraiosis:possibleabnormalities in blood-brain barrier function[J]. JNeurol Sci,1993,115:125-131.98 Wallin A,Sjögren M,Edman A,et al. Symptoms,vascular risk factors and blood-brain barrier function142 Chin J Stroke, Feb 2017, Vol 12, No.2in relation to CT white-matter changes in dementia[J].Eur Neurol,2000,44:229-235.99 Taheri S,Gasparovic C,Shah NJ,et al. Quantitativemeasurement of blood-brain barrier permeabilityin human using dynamic contrast-enhanced MRIwith fast T1 mapping[J]. Magn Reson Med,2011,65:1036-1042.100 Hansson J,Vasan RS,Ärnlöv J,et al. Biomarkers ofextracellular matrix metabolism (MMP-9 and TIMP-1) and risk of stroke,myocardial infarction,andcause-specific mortality:cohort study[J]. PLoS One,2011,6:e16185.101 G iwa MO,Wi l l iams J,Elde r f ield K,e t a l .Neuropathologic evidence of endothelial changes incerebral small vessel disease[J]. Neurology,2012,78:167-174.102 Hu J,wanden Steen PE,Sang QX,et al. Matrixmet al loproteinase inhibitor s a s therapy forinflammatory and vascular diseases[J]. Nat Rev DrugDiscov,2007,6:480-498. |
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