脑微出血发生机制的研究进展

Research Progress in Mechanism of Cerebral Microbleeds

脑小血管病是临床常见的与年龄相关的脑血管疾病,隐匿起病,发展缓慢,显著增加了未来卒中的发生风险,临床上常缺乏特异性表现,患者可出现认知功能下降、精神情感改变、步态障碍、吞咽及排尿功能异常等。脑微出血(CMBs)是脑小血管病的重要类型之一,主要依据影像学进行诊断,在磁共振T2*加权梯度回波或磁敏感加权成像上表现为小的圆形或卵圆形、边界清楚、均质的低信号影。目前认为CMBs的病理机制有两种,即由高血压等心血管危险因素所致的小血管玻璃样变性和血管淀粉样变性所致的微小血管壁损害。

Small cerebral vascular disease is a common age-related cerebrovascular disease in clinical practice.It has a hidden onset and slow development,which significantly increases the risk of future stroke.The clinical manifestations are often lack of specificity,and the patients may have cognitive decline,mental and emotional changes,gait disorders,swallowing and urination abnormalities.Cerebral microbleeds(CMBs) is one of the important types of cerebral small vessel disease.The diagnosis is mainly based on imaging,showing small round or oval,clear boundary and homogeneous low-signal shadow on magnetic resonance T2* weighted gradient echo or magnetic-sensitive weighted imaging.Currently,there are two kinds of pathological mechanisms: the hyaline degeneration of small blood vessels caused by cardiovascular risk factors such as hypertension;microvascular wall damage caused by vascular amyloidosis.