脑小血管病和脑微循环研究进展

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。

Progress in Research of Cerebral Small Vessel Disease and Cerebral Microcirculation

Cerebral small vessel disease (CSVD) refers to a syndrome caused by pathophysiologic changes of cerebral microcirculation (including cerebral small vessels or the microvessels) and it can result in acute stroke, cognitive impairment, and many other clinical manifestations. Arteriolosclerosis, embolism, endothelial dysfunction, blood-brain barrier damage, amyloid deposition, cerebral hypoperfusion and venous collagenosis of cerebral microcirculation are thought to be closely associated with the pathogenesis of CSVD, which provide new strategies for its treatment. A definite diagnosis of this disease relies on biopsy, which usually indicates that it is the end stage of the disease. Also, it is difficult to obtain histopathologic materials, so clinical diagnosis is mainly dependent on neuroimaging. This review discusses the manifestations, classification, pathophysiologic mechanisms and clinical examinations related to cerebral microcirculation, so as to ifnd new diagnostic and therapeutic strategies for cerebral small vessel disease.