脑类淋巴系统在脑小血管病中的研究进展

The role of glymphatic system in cerebral small vessel disease

脑类淋巴系统由动脉旁间隙的流入通路、脑实质内脑脊液和组织液的交换通路和静脉旁间隙流出通路组成,是引流脑脊液和清除代谢物质的重要途径。目前,已发现类淋巴系统功能紊乱与多种神经退行性疾病相关,然而鲜有关于脑小血管病领域的相关探索。本文首先就血管周围间隙这一解剖结构进行介绍,详细地分析了脑类淋巴系统与脑小血管病各发病机制之间的联系,最终探讨了脑类淋巴系统在脑小血管的临床症状尤其是痴呆中起的作用。可见,重视脑类淋巴系统在脑小血管病中的作用,以全新的视角理解脑小血管病和脑类淋巴系统的相互关系,具有较大的科学和临床意义。

The glymphatic system is an important pathway which promotes movement of cerebrospinal fluid(CSF)into the brain and clearance of metabolic waste of the brain.It consists of CSF influx along periarterial space,CSF-interstitial fluid(ISF)exchange and CSF exflux along perivenous space.The impairment of glymphatic function has been found to be associated with a variety of neurodegenerative diseases,such as Alzheimer's disease and Parkinson's disease.However,few researches focus on the role of the glymphatic system in cerebral small vessel disease(CSVD).In this review,the perivascular space is introduced firstly,and the relationship between the glymphatic system and the pathogenesis of CSVD is analyzed in detail.Finally,the role of the glymphatic system in the clinical symptoms of CSVD,especially in dementia is discussed.Above all,it is of great scientific and clinical significance to pay attention to the role of glymphatic system in CSVD.