Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension a...Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.展开更多
脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔...脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。展开更多
目的探讨缺血性脑白质损害(ischemic white matter lesion,IWML)与脑梗死的临床疗效与转归,研究脑小血管病变(cerebral small vessel disease,CSVD)的防治措施。方法经头部MRI检测符合缺血性脑白质病变(IWML)患者28例,影像学显示主要表...目的探讨缺血性脑白质损害(ischemic white matter lesion,IWML)与脑梗死的临床疗效与转归,研究脑小血管病变(cerebral small vessel disease,CSVD)的防治措施。方法经头部MRI检测符合缺血性脑白质病变(IWML)患者28例,影像学显示主要表现为脑室周围片状的白质信号改变。脑梗死(大面积脑梗死除外)患者31例,对两组患者进行规范化治疗,作入院时及1年后随访的NIHSS、MMSE、BI指数以及HAMD的临床测试及评分。对两组患者进行疗效对比分析。结果从NIHSS、MMSE、BI指数及HAMD检测可看出,IWML患者入院时NIHSS、BI指数明显好于脑梗死组,1年后随访比较变化也不明显(0.05>P>0.01),MMSE较脑梗死组差,而HAMD测试分数明显高于脑梗死组,1年后随访发现分值反而有所增高,统计分析有显著差异(P<0.01)。脑梗死组患者入院时MMSE、HAMD均较正常,而NIHSS、BI指数较IWML组差,1年后随访比较,NIHSS、BI指数变化明显,统计分析有显著性差异(P<0.01)。结论从本研究的对比分析中可看出,缺血性脑白质病变发展到一定程度,将逐渐引起全脑性的血脑屏障破坏,可导致血管性认知障碍以及血管性抑郁等,治疗效果很不理想。而脑梗死患者病变是突发的,相对来说对脑的损伤也是局部性的。经积极治疗病情恢复得较快。两组患者某些危险因素是相同的,发病机制有相同、也有不同,但临床疗效及转归是完全不同的。展开更多
脑小血管病(cerebral small vessel disease,CSVD)在影像学上主要以腔隙性梗死、白质病变和脑微出血的形态存在。静止性CSVD与认知功能障碍密切相关,其导致的认知功能障碍主要表现为执行功能障碍、反应迟钝和注意力下降等,与病灶部位、...脑小血管病(cerebral small vessel disease,CSVD)在影像学上主要以腔隙性梗死、白质病变和脑微出血的形态存在。静止性CSVD与认知功能障碍密切相关,其导致的认知功能障碍主要表现为执行功能障碍、反应迟钝和注意力下降等,与病灶部位、数量和大小相关。本文就静止性CSVD的主要影像学表现及其与认知功能障碍的关系作一综述,以期加深临床医生对静止性CSVD及其危害的认识并提高识别率,由此尽早干预而延缓患者认知功能障碍的发生和发展,提高患者的生活质量。展开更多
基金supported by the National Natural Science Foundation of China,Nos.82274611 (to LZ),82104419 (to DM)Capital Science and Technology Leading Talent Training Project,No.Z1 91100006119017 (to LZ)+3 种基金Beijing Hospitals Authority Ascent Plan,No.DFL20190803 (to LZ)Cultivation Fund of Hospital Management Center in Beijing,No.PZ2022006 (to DM)R&D Program of Beijing Municipal Education Commission,No.KM202210025017 (to DM)Beijing Gold-Bridge Project,No.ZZ20145 (to DM)。
文摘Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
文摘脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。
文摘目的探讨缺血性脑白质损害(ischemic white matter lesion,IWML)与脑梗死的临床疗效与转归,研究脑小血管病变(cerebral small vessel disease,CSVD)的防治措施。方法经头部MRI检测符合缺血性脑白质病变(IWML)患者28例,影像学显示主要表现为脑室周围片状的白质信号改变。脑梗死(大面积脑梗死除外)患者31例,对两组患者进行规范化治疗,作入院时及1年后随访的NIHSS、MMSE、BI指数以及HAMD的临床测试及评分。对两组患者进行疗效对比分析。结果从NIHSS、MMSE、BI指数及HAMD检测可看出,IWML患者入院时NIHSS、BI指数明显好于脑梗死组,1年后随访比较变化也不明显(0.05>P>0.01),MMSE较脑梗死组差,而HAMD测试分数明显高于脑梗死组,1年后随访发现分值反而有所增高,统计分析有显著差异(P<0.01)。脑梗死组患者入院时MMSE、HAMD均较正常,而NIHSS、BI指数较IWML组差,1年后随访比较,NIHSS、BI指数变化明显,统计分析有显著性差异(P<0.01)。结论从本研究的对比分析中可看出,缺血性脑白质病变发展到一定程度,将逐渐引起全脑性的血脑屏障破坏,可导致血管性认知障碍以及血管性抑郁等,治疗效果很不理想。而脑梗死患者病变是突发的,相对来说对脑的损伤也是局部性的。经积极治疗病情恢复得较快。两组患者某些危险因素是相同的,发病机制有相同、也有不同,但临床疗效及转归是完全不同的。
文摘脑小血管病(cerebral small vessel disease,CSVD)在影像学上主要以腔隙性梗死、白质病变和脑微出血的形态存在。静止性CSVD与认知功能障碍密切相关,其导致的认知功能障碍主要表现为执行功能障碍、反应迟钝和注意力下降等,与病灶部位、数量和大小相关。本文就静止性CSVD的主要影像学表现及其与认知功能障碍的关系作一综述,以期加深临床医生对静止性CSVD及其危害的认识并提高识别率,由此尽早干预而延缓患者认知功能障碍的发生和发展,提高患者的生活质量。
