中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (7): 1454-1462.doi: 10.4103/1673-5374.385841

• 综述:退行性病与再生 • 上一篇    下一篇

高血压致脑小血管病患者的认知障碍

  

  • 出版日期:2024-07-15 发布日期:2023-11-28
  • 基金资助:
    中国国家自然科学基金项目(82274611,82104419);首都科技领军人才培养项目(Z191100006119017);医院管理局提升计划(DFL2020190803);北京市医院管理中心培育基金(PZ2022006);北京市教委研发计划(KM202210025017);北京金桥项目(ZZ20145)

Cognitive impairment in cerebral small vessel disease induced by hypertension

Weipeng Wei1, 2, Denglei Ma1, 2, Lin Li1, 2, Lan Zhang1, 2, *   

  1. 1Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China; 2Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
  • Online:2024-07-15 Published:2023-11-28
  • Contact: Lan Zhang, PhD, xwzhanglan@126.com.
  • Supported by:
    This work was 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. Z191100006119017 (to LZ); 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); and Beijing Gold-Bridge Project, No. ZZ20145 (to DM).

摘要:

高血压是脑小血管病引起认知障碍进展的主要危险因素之一,然而两者间的因果关系尚不清楚。高血压对大脑健康的负面影响是巨大的,已被公认为是脑血管疾病的危险因素。高血压的持续时间和生活方式因素与脑卒中和痴呆的风险有关。脑小血管病则是最常见的脑血管疾病之一,也可导致脑卒中和痴呆。众所周知,高血压是脑小血管病的主要驱动因素,而脑小血管病也可通过多种机制改变脑血管的结构和功能,导致腔隙性梗死、脑白质疏松、白质病变和脑出血,进而造成认知能力下降。因此,这种血管性脑损伤可能是证明大脑及其功能是高血压引起的靶器官损伤后认知障碍的早期靶点。此次综述分析了近年来高血压致脑小血管病的发病机制、脑功能结构变化和认知能力变化方面以及药物治疗脑小血管病和认知功能障碍方面的最新研究进展,以期为预防脑小血管病认知功能的提供帮助。

https://orcid.org/0000-0003-0740-6751 (Lan Zhang)

关键词: 高血压, 脑小血管病, 认知障碍, 痴呆, 白质高信号, 血脑屏障, 神经炎症, 血管周围间隙, 腔隙性梗死, 内皮功能障碍, 治疗

Abstract: Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease, the most common cerebrovascular disease. However, 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 stroke 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 resulting in cognitive decline and demonstrating that the brain is the target organ of hypertension. This review updates our understanding of the pathogenesis of hypertension-induced cerebral small vessel disease and the resulting changes in brain structure and function and declines in cognitive ability. We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.

Key words: blood-brain barrier, cerebral small vessel disease, cognitive impairment, dementia, endothelial dysfunction, enlarged perivascular space, hypertension, lacunar infarction, neuroinflammation, treatment, white matter high signal intensity