脑微出血研究进展
Recent Advances in Research on Cerebral Microbleeds
DOI: 10.12677/acm.2025.15123601, PDF,   
作者: 马灵虎：西安医学院第一附属医院神经内科，陕西 西安；西安医学院研究生工作部，陕西 西安；徐云飞, 汪真真, 周 婷, 王乐乐, 高 飞*：西安医学院第一附属医院神经内科，陕西 西安
关键词: 脑微出血；危险因素；发病机制；抗血栓治疗；Cerebral Microbleeds； Risk Factors； Pathogenesis； Antithrombotic Therapy
摘要: 脑微出血(CMB)是脑小血管病的影像学标志物之一，患病率随年龄增长而增加，脑内小血管病变可导致含铁血黄素沉积，在SWI等磁共振序列上呈特征性改变。高血压、脑淀粉样血管病、糖尿病、高同型半胱氨酸血症、阻塞性睡眠呼吸暂停及吸烟等是CMB的主要危险因素。CMB与认知功能下降、卒中(出血性与缺血性)及卒中后抑郁等临床结局显著相关。在治疗方面，CMB的存在与数量对静脉溶栓及抗血小板、抗凝治疗决策具有重要影响，需个体化权衡出血与血栓风险。未来研究需致力于CMB的早期精准识别、风险分层模型的建立以及针对性干预策略的开发，以改善患者预后并减轻社会负担。
Abstract: Cerebral microbleeds (CMB) are one of the imaging markers for cerebral small vessel disease, with prevalence increasing with age. Intracerebral small vessel lesions can lead to hemosiderin deposition, presenting characteristic changes on magnetic resonance sequences such as SWI. Hypertension, cerebral amyloid angiopathy, diabetes, hyperhomocysteinemia, obstructive sleep apnea, and smoking are major risk factors for CMB. CMB is significantly associated with clinical outcomes including cognitive decline, stroke (both hemorrhagic and ischemic), and post-stroke depression. Therapeutically, the presence and number of CMB critically influence decisions regarding intravenous thrombolysis and antiplatelet, anticoagulant therapy, necessitating individualized risk-benefit assessments balancing hemorrhagic and thrombotic risks. Future research should focus on early and precise identification of CMB, establishing risk stratification models, and developing targeted intervention strategies to improve patient outcomes and reduce societal burden.
文章引用：马灵虎, 徐云飞, 汪真真, 周婷, 王乐乐, 高飞. 脑微出血研究进展[J]. 临床医学进展, 2025, 15(12): 1843-1849. https://doi.org/10.12677/acm.2025.15123601

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