脑小血管疾病--关于慢性脑缺血的新观点

E. A. Shirokov, О. A. Sapronenkova
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引用次数: 0

摘要

脑小血管病(CSVD)是微循环血管床的一种异质性疾病,可导致认知障碍、腔隙性中风和脑内出血。CSVD 的发病机制以血管壁细胞间基质结构紊乱为特征,导致病理蛋白堆积、透明质酸化、坏死和血脑屏障通透性增加。疾病进展与微血管床面积缩小、炎症过程、萎缩和脱髓鞘有关。文章介绍了 CSVD 的病理分类,讨论了诊断和治疗原则。文章特别关注了治疗慢性小动脉病变患者的有效方法。文章提出并论证了使用不同制药集团的血管扩张剂的原则,还讨论了使用全身蛋白水解酶和血小板抗聚集剂的前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cerebral small vessel disease — new ideas about chronic cerebral ischemia
Cerebral small vessel disease (CSVD) is a heterogeneous disease of the microcirculatory vessel bed, leading to the development of cognitive impairments, lacunar strokes, and intracerebral hemorrhages. The pathogenesis of CSVD is characterized by disturbances in the structure of the intercellular matrix of the vessel wall, resulting in the accumulation of pathological proteins, hyalinosis, necrosis, and increased permeability of the blood-brain barrier. Disease progression is associated with a decrease in the area of the microvascular bed, inflammatory processes, atrophy, and demyelination. The article presents a pathogenetic classification of CSVD, discusses principles of diagnosis and treatment. Special attention is given to promising approaches for managing patients with chronic small artery pathology. Principles for the use of vasodilators from various pharmaceutical groups are proposed and justified, along with discussions on the prospects of using systemic proteolytic enzymes and platelet anti-aggregants.
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