|
脑小血管疾病的危险因素和发病机制
|
Abstract:
脑小血管病(CSVD)是一种大脑微血管疾病,可破坏血脑屏障,影响脑部组织的微循环,导致脑组织局部病变的疾病。这种疾病占缺血性卒中的20%~25%,也是痴呆的45%左右的常见原因,但其发病机制尚不清楚,本文对目前主要的脑小血管病的病因及发病机制进行综述,为临床对该病的诊治提供参考。
Cerebral small vessel disease (CSVD) is a type of cerebral microvascular disease that can damage the blood-brain barrier, affect microcirculation in brain tissue, and lead to local lesions in brain tissue. This disease accounts for 20%~25% of ischemic stroke and is also a common cause of about 45% of dementia, but its pathogenesis is still unclear. This article reviews the etiology and pathogenesis of the main cerebral small vessel diseases, providing reference for clinical diagnosis and treatment of this disease.
[1] | 张阳, 何俐. 脑小血管病的病因和发病机制的最新进展[J]. 中风与神经疾病杂志, 2024, 41(4): 296-297. |
[2] | 何俐. 脑小血管病的病因和发病机制[J]. 中国实用内科杂志, 2021, 41(7): 564-566. |
[3] | Huisa, B.N., Caprihan, A., Thompson, J., Prestopnik, J., Qualls, C.R. and Rosenberg, G.A. (2015) Long-Term Blood-Brain Barrier Permeability Changes in Binswanger Disease. Stroke, 46, 2413-2418. https://doi.org/10.1161/strokeaha.115.009589 |
[4] | Kerkhofs, D., Wong, S.M., Zhang, E., Uiterwijk, R., Hoff, E.I., Jansen, J.F.A., et al. (2021) Blood-Brain Barrier Leakage at Baseline and Cognitive Decline in Cerebral Small Vessel Disease: A 2-Year Follow-Up Study. GeroScience, 43, 1643-1652. https://doi.org/10.1007/s11357-021-00399-x |
[5] | Szpak, G.M., Lewandowska, E., Sliwińska, A., et al. (2011) Inflammatory Cerebral Amyloid Angiopathy: The Overlap of Perivascular (PAN-Like) with Vasculitic (Aβ-Related Angiitis) Form: An Autopsy Case. Folia Neuropathologica, 49, 335-347. |
[6] | De Silva, T.M. and Faraci, F.M. (2020) Contributions of Aging to Cerebral Small Vessel Disease. Annual Review of Physiology, 82, 275-295. https://doi.org/10.1146/annurev-physiol-021119-034338 |
[7] | Trache, A., Massett, M.P. and Woodman, C.R. (2020) Vascular Smooth Muscle Stiffness and Its Role in Aging. Current Topics in Membranes, 86, 217-253. https://doi.org/10.1016/bs.ctm.2020.08.008 |
[8] | Ojha, K.R., Shin, S.Y., Padgham, S., Leon Olmedo, F., Guo, B., Han, G., et al. (2022) Age-Associated Dysregulation of Integrin Function in Vascular Smooth Muscle. Frontiers in Physiology, 13, Article 913673. https://doi.org/10.3389/fphys.2022.913673 |
[9] | Sun, Y., Wang, X., Liu, T., Zhu, X. and Pan, X. (2022) The Multifaceted Role of the SASP in Atherosclerosis: From Mechanisms to Therapeutic Opportunities. Cell & Bioscience, 12, Article No. 74. https://doi.org/10.1186/s13578-022-00815-5 |
[10] | 李溢溪, 刘启明, 刘娜, 等. 间充质干细胞抗衰老研究进展[J]. 中国动脉硬化杂志, 2020, 28(11): 997-1001. |
[11] | 陆正齐. 炎症、免疫与脑血管病的研究进展[J]. 中山大学学报(医学科学版), 2021, 42(1): 11-16. |
[12] | Craggs, L.J.L., Yamamoto, Y., Deramecourt, V. and Kalaria, R.N. (2014) Microvascular Pathology and Morphometrics of Sporadic and Hereditary Small Vessel Diseases of the Brain. Brain Pathology, 24, 495-509. https://doi.org/10.1111/bpa.12177 |
[13] | Sun, Z., Gao, C., Gao, D., Sun, R., Li, W., Wang, F., et al. (2021) Reduction in Pericyte Coverage Leads to Blood-Brain Barrier Dysfunction via Endothelial Transcytosis Following Chronic Cerebral Hypoperfusion. Fluids and Barriers of the CNS, 18, Article No. 21. https://doi.org/10.1186/s12987-021-00255-2 |
[14] | Liu, Y., Dong, Y., Lyu, P., Chen, W. and Li, R. (2018) Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment. Chinese Medical Journal, 131, 615-619. https://doi.org/10.4103/0366-6999.226069 |
[15] | Zhao, B., Jia, W., Yuan, Y., Chen, Y., Gao, Y., Yang, B., et al. (2024) Impact of Blood Pressure Variability and Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis. Heliyon, 10, e33264. https://doi.org/10.1016/j.heliyon.2024.e33264 |
[16] | 刘艳, 赵凤丽, 周卫东. 血管周围间隙扩大与脑小血管病关系研究进展[J]. 中国神经免疫学和神经病学杂志, 2017, 24(6): 430-434. |
[17] | Tinajero, M.G. and Malik, V.S. (2021) An Update on the Epidemiology of Type 2 Diabetes. Endocrinology and Metabolism Clinics of North America, 50, 337-355. https://doi.org/10.1016/j.ecl.2021.05.013 |
[18] | Yuan, T., Yang, T., Chen, H., Fu, D., Hu, Y., Wang, J., et al. (2019) New Insights into Oxidative Stress and Inflammation during Diabetes Mellitus-Accelerated Atherosclerosis. Redox Biology, 20, 247-260. https://doi.org/10.1016/j.redox.2018.09.025 |
[19] | Rodriguez-Gutierrez, R., Gonzalez-Gonzalez, J.G., Zuñiga-Hernandez, J.A. and McCoy, R.G. (2019) Benefits and Harms of Intensive Glycemic Control in Patients with Type 2 Diabetes. BMJ, 367, l5887. https://doi.org/10.1136/bmj.l5887 |
[20] | Kaplan, P., Tatarkova, Z., Sivonova, M.K., Racay, P. and Lehotsky, J. (2020) Homocysteine and Mitochondria in Cardiovascular and Cerebrovascular Systems. International Journal of Molecular Sciences, 21, Article 7698. https://doi.org/10.3390/ijms21207698 |
[21] | Yuan, D., Chu, J., Lin, H., Zhu, G., Qian, J., Yu, Y., et al. (2023) Mechanism of Homocysteine-Mediated Endothelial Injury and Its Consequences for Atherosclerosis. Frontiers in Cardiovascular Medicine, 9, Article 1109445. https://doi.org/10.3389/fcvm.2022.1109445 |
[22] | 孙笛, 单海燕. 同型半胱氨酸与动脉粥样硬化及认知功能障碍的相关性研究进展[J]. 中国实用乡村医生杂志, 2021, 28(12): 33-36, 39. |
[23] | Ndrepepa, G. (2018) Uric Acid and Cardiovascular Disease. Clinica Chimica Acta, 484, 150-163. https://doi.org/10.1016/j.cca.2018.05.046 |
[24] | Arteaga-Reyes, C., Sen, D., Rudilosso, S., Jouvent, E., Hervé, D., Lindgren, A.G., et al. (2025) Time to Consider Health Services Dedicated for Adults Living with Cerebral Small Vessel Disease: Report of a ESO Scientific Seminar. European Stroke Journal. https://doi.org/10.1177/23969873241309506 |