脑淀粉样血管病相关性脑出血的临床研究现状

Clinical research status of cerebral hemorrhage associated with cerebral amyloid angiopathy

脑淀粉样血管病相关性脑出血(CAAH)是导致自发性脑出血的第二常见病因,仅次于高血压脑出血,占自发性脑出血的15%~40%。目前研究认为β淀粉样蛋白(Aβ)沉积于软脑膜和皮质的动脉、微动脉以及毛细血管壁内,损害血管壁的完整性,并增加受累血管的脆性是导致脑出血的重要机制。尽管CAAH术中止血困难,但随着治疗方法的深入研究,明确可外科治疗的安全性及有效性。本文对近期有关CAAH的机制、病理特点、影像学表现、治疗方法的相关文献进行梳理,对目前CAAH的研究现状进行综述,以改变人们对CAAH的传统认识。

The cerebral amyloid angiopathy associated cerebral hemorrhage(CAAH)is the second leading cause of spontaneous cerebral hemorrhage,next to hypertensive cerebral hemorrhage,accounting for 15%~40%of spontaneous cerebral hemorrhage.Current research considers that amyloidβ-protein(Aβ),Aβdeposits in the arteries,arterioles and capillary walls of the pia mater and cortex,which damage the integrity of the vascular wall and increase the fragility of the involved vessels is an important mechanism leading to cerebral hemorrhage.Although it is difficult to stop bleeding during the operation of CAAH,the safety and effectiveness of surgical treatment are clear with the infiltration of treatment methods.This article summarizes the current research status of CAAH based on the relevant Chinese and foreign literatures on the mechanism,pathological characteristics,imaging manifestations,and treatment methods of CAAH to change people's traditional understanding of CAAH.