Cerebral small vessel disease: Capillary pathways to stroke and cognitive decline.
Cerebral small vessel disease: Capillary pathways to stroke and cognitive decline.
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DOI：
10.1177/0271678x15606723
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发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
Muir KW
中科院分区：
文献类型：
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作者：
Østergaard L;Engedal TS;Moreton F;Hansen MB;Wardlaw JM;Dalkara T;Markus HS;Muir KW
脑血管疾病（SVD）导致全世界五分之一的中风，是老年人认知能力下降的一个主要原因。已知SVD与高血压、糖尿病、吸烟、放射治疗以及一系列遗传性和遗传性疾病、自身免疫性疾病、结缔组织疾病和感染有关。直到最近，毛细血管通畅和血液粘度的变化在SVD的发病机制以及随后卒中和认知能力下降的高风险中很少受到关注。然而，最近发现毛细血管流动模式限制了组织中氧气的提取效果，因此，即使在没有物理血流限制血管病理的情况下，毛细血管功能障碍也被认为是中风样症状和神经变性的来源。在这篇综述中，我们研究了毛细血管流动紊乱是否可能是代表SVD危险因素的条件的共同特征。然后，我们讨论了可以预防或减轻毛细血管功能障碍的方面，因此可能对有SVD，中风或认知能力下降风险的患者普遍有益。
Cerebral small vessel disease (SVD) gives rise to one in five strokes worldwide and constitutes a major source of cognitive decline in the elderly. SVD is known to occur in relation to hypertension, diabetes, smoking, radiation therapy and in a range of inherited and genetic disorders, autoimmune disorders, connective tissue disorders, and infections. Until recently, changes in capillary patency and blood viscosity have received little attention in the aetiopathogenesis of SVD and the high risk of subsequent stroke and cognitive decline. Capillary flow patterns were, however, recently shown to limit the extraction efficacy of oxygen in tissue and capillary dysfunction therefore proposed as a source of stroke-like symptoms and neurodegeneration, even in the absence of physical flow-limiting vascular pathology. In this review, we examine whether capillary flow disturbances may be a shared feature of conditions that represent risk factors for SVD. We then discuss aspects of capillary dysfunction that could be prevented or alleviated and therefore might be of general benefit to patients at risk of SVD, stroke or cognitive decline.