血流重建术与血管性认知障碍的研究进展

Advances in the Study of Blood Flow Reconstruction and Vascular Cognitive Impairment

颈动脉狭窄或大脑中动脉狭窄会导致颅内血流下降,进而导致认知功能障碍,血流重建术是恢复颅内血流的重要方法。血流重建术可降低卒中发病率,提高颅内灌注压,改善脑代谢,从而改善认知功能,但术后高灌注、微栓塞又是引起认知功能下降的另一危险因素,不可忽视的是年龄,基础疾病导致的认知功能下降。目前血流重建术是否可以改善认知功能,仍存较大争议,无症状性颅内血管重度狭窄是否需要进行血流重建术,临床尚无定论。目前将血流重建术与血管性认知障碍研究进展进行综述。

Carotid artery stenosis or middle cerebral artery stenosis will lead to intracranial blood flow decline, leading to cognitive dysfunction. Blood flow reconstruction is an important method to restore intracranial blood flow. Blood flow reconstruction can reduce the incidence of stroke, improve intracranial perfusion pressure, improve cerebral metabolism, and thus improve cognitive function. However, postoperative high perfusion and microembolism are another risk factor for cognitive decline, which cannot be ignored is the decline in cognitive function caused by age and underlying diseases. At present, there is still a great debate on whether reconstructive surgery can improve cognitive function. Whether reconstructive surgery is necessary for asymptomatic severe intracranial vascular stenosis has not been concluded clinically. The research progress of blood flow reconstruction and vascular cognitive impairment is reviewed.