脑小血管疾病的危险因素和发病机制
Risk Factors and Pathogenesis of Cerebral Small Vessel Disease
DOI: 10.12677/jcpm.2025.42159, PDF,   
作者: 刁德敦*：延安大学咸阳医院神经内科，陕西 咸阳；延安大学医学院，陕西 延安；王丙聚#：延安大学咸阳医院神经内科，陕西 咸阳；姜 珊, 袁 薇：延安大学医学院，陕西 延安
关键词: 脑小血管病；血脂；高血压；糖尿病；年龄；遗传因素；高同型半胱氨酸；Cerebral Small Vessel Disease； Blood Lipids； Hypertension； Diabetes； Age； Genetic Factors； High Homocysteine
摘要: 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。
Abstract: 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.
文章引用：刁德敦, 王丙聚, 姜珊, 袁薇. 脑小血管疾病的危险因素和发病机制[J]. 临床个性化医学, 2025, 4(2): 164-169. https://doi.org/10.12677/jcpm.2025.42159

参考文献

[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]
[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. [Google Scholar] [CrossRef] [PubMed]