{"id":44994,"date":"2024-12-15T05:10:28","date_gmt":"2024-12-15T05:10:28","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=44994"},"modified":"2024-12-15T05:10:28","modified_gmt":"2024-12-15T05:10:28","slug":"%e5%8d%81%e5%b9%b4%e9%87%8c%e7%a8%8b%e7%a2%91%ef%bc%81%e8%84%91%e5%b0%8f%e8%a1%80%e7%ae%a1%e7%97%85%e5%9b%bd%e9%99%85%e5%bd%b1%e5%83%8f%e6%a0%87%e5%87%862023%e5%8f%91%e5%b8%83","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=44994","title":{"rendered":"\u5341\u5e74\u91cc\u7a0b\u7891\uff01\u8111\u5c0f\u8840\u7ba1\u75c5\u56fd\u9645\u5f71\u50cf\u6807\u51c62023\u53d1\u5e03"},"content":{"rendered":"<\/p>\n

\u8111\u5c0f\u8840\u7ba1\u75c5<\/p>\n

Cerebral Small Vessel Disease, CSVD<\/p>\n

\u8111\u5c0f\u8840\u7ba1\u75c5 (Cerebral Small Vessel Disease, CSVD) \u662f\u6307\u8111\u5c0f\u52a8\u8109\u3001\u5c0f\u9759\u8109\u53ca\u6bdb\u7ec6\u8840\u7ba1\u75c5\u53d8\u6240\u5bfc\u81f4\u7684\u8111\u9000\u884c\u6027\u53d8\u75be\u75c5[1]<\/sup>\u3002<\/p>\n

\u78c1\u5171\u632f\u56fe\u50cf\u4e0a\u53ef\u8868\u73b0\u4e3a\u8111\u767d\u8d28\u9ad8\u4fe1\u53f7\u3001\u8154\u9699\u3001\u5fae\u51fa\u8840\u7b49\u5f71\u50cf\u5b66\u8868\u73b0[1]<\/sup>\u3002<\/p>\n

CSVD\u572865\u5c81\u4ee5\u4e0a\u8001\u5e74\u4eba\u4e2d\u7684\u60a3\u75c5\u7387\u9ad8\u8fbe80~90%\uff0c\u968f\u7740\u793e\u4f1a\u8001\u9f84\u5316\u52a0\u901f\uff0cCSVD\u5e26\u6765\u7684\u5f71\u54cd\u662f\u5de8\u5927\u7684\u3002\u76ee\u524d\uff0cCSVD\u5df2\u6210\u4e3a\u795e\u7ecf\u79d1\u5b66\u9886\u57df\u4e2d\u7684\u91cd\u8981\u8bdd\u9898\u3002<\/p>\n

\u5341\u5e74\u524d\u76842013\u5e74\uff0c\u67f3\u53f6\u5200\u795e\u7ecf\u75c5\u5b66 (Lancet
\nNeurology\uff0cIF=59.9) \u53d1\u5e03\u4e86CSVD\u7684\u56fd\u9645\u5f71\u50cf\u6807\u51c6STRIVE (Standards
\nfor Reporting Vascular Changes on
\nNeuroimaging) [1]<\/sup>\u3002\u4e4b\u540e\uff0cSTRIVE\u6210\u4e3aCSVD\u9886\u57df\u516c\u8ba4\u7684\u56fd\u9645\u6807\u51c6\u3002\u56fd\u9645\u6807\u51c6\u7684\u786e\u7acb\u5927\u5927\u4fc3\u8fdb\u4e86CSVD\u9886\u57df\u7684\u53d1\u5c55\u3002<\/p>\n<\/p>\n

\u5341\u5e74\u95f4\uff0c\u56fd\u5185\u5916\u7814\u7a76\u5b66\u8005\u4e3aCSVD\u9886\u57df\u5e26\u6765\u4e86\u8bb8\u591a\u65b0\u7684\u7a81\u7834\u3001\u65b0\u7684\u53d1\u73b0\uff0cCSVD\u5bf9\u8111\u5065\u5eb7\u7684\u6df1\u8fdc\u5f71\u54cd\u7684\u8ba4\u77e5\u8d8a\u6765\u8d8a\u5177\u4f53\uff1a<\/p>\n

CSVD\u4e0e\u8ba4\u77e5\u969c\u788d\u5173\u7cfb\u5bc6\u5207\uff0c\u4f1a\u4f7f\u672a\u6765\u75f4\u5446\u6216\u6b7b\u4ea1\u98ce\u9669\u589e\u52a0\u4e00\u500d\uff1b\u4e0e\u5168\u4e16\u754c\u4e00\u534a\u7684\u75f4\u5446\u53d1\u751f\u76f8\u5173[2,3]\u3002<\/sup><\/p>\n

2023\u5e74\uff0c\u7b2c\u4e8c\u7248\u7684STRIVE (STRIVE-2) \u5728\u7ecf\u5386\u4e00\u5e74\u534a\u7684\u7814\u7a76\u8ba8\u8bba\u540e\uff0c\u4e8e\u8fd1\u65e5\u53d1\u5e03\u5728Lancet
\nNeurology (IF=59.9) \u4e0a\uff0c\u8fd9\u4e00\u4efd\u753150\u540d\u4e13\u5bb6\u548c4\u540d\u5916\u90e8\u987e\u95ee\u8fbe\u6210\u7684\u5171\u8bc6\u5c06\u4f1a\u662fCSVD\u9886\u57df\u8bca\u65ad\u6807\u51c6\u4e2d\u7684\u65b0\u91cc\u7a0b\u7891\u3002\u90a3\u4e48\uff0c\u56fd\u5185\u5916\u5b66\u8005\u7684\u5341\u5e74\u8015\u8018\uff0cCSVD\u9886\u57df\u53d1\u751f\u600e\u6837\u4e86\u53d8\u5316\uff1f<\/p>\n

\u6211\u4eec\u6b23\u559c\u5730\u53d1\u73b0\uff0c\u4ee5\u5317\u4eac\u534f\u548c\u533b\u9662\u7684\u6731\u4ee5\u8bda\u6559\u6388\u3001\u9996\u90fd\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u5317\u4eac\u5929\u575b\u533b\u9662\u7684\u738b\u4f0a\u9f99\u6559\u6388\u4e3a\u4ee3\u8868\u7684\u5b66\u8005\u5728CSVD\u9886\u57df\u505a\u51fa\u4e86\u7a81\u51fa\u7684\u8d21\u732e\uff0c\u6210\u4e3a\u5236\u5b9aSTRIVE-2\u7684\u56fd\u9645\u4e13\u5bb6\u7ec4\u3002\u5317\u4eac\u534f\u548c\u533b\u9662\u6731\u4ee5\u8bda\u6559\u6388\u5317\u4eac\u534f\u548c\u533b\u9662\u795e\u7ecf\u79d1\u4e3b\u4efb\uff0c\u4e3b\u4efb\u533b\u5e08\uff0c\u6559\u6388\uff0c\u535a\u58eb\u7814\u7a76\u751f\u5bfc\u5e08\u3002\u4e2d\u534e\u533b\u5b66\u4f1a\u795e\u7ecf\u75c5\u5b66\u5206\u4f1a\u59d4\u5458\uff0c\u5317\u4eac\u533b\u5e08\u534f\u4f1a\u795e\u7ecf\u5185\u79d1\u4e13\u79d1\u533b\u5e08\u5206\u4f1a\u526f\u4f1a\u957f\uff0c\u300a\u4e2d\u534e\u795e\u7ecf\u79d1\u6742\u5fd7\u300b\u7f16\u59d4\uff0c\u300a\u7f55\u89c1\u75c5\u7814\u7a76\u300b\u526f\u4e3b\u7f16\u3002<\/p>\n

\u9996\u90fd\u533b\u79d1\u5927\u5b66<\/p>\n

\u9644\u5c5e\u5317\u4eac\u5929\u575b\u533b\u9662<\/p>\n

\u738b\u4f0a\u9f99\u6559\u6388<\/p>\n

\u9996\u90fd\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u5317\u4eac\u5929\u575b\u533b\u9662\u526f\u9662\u957f\uff0c\u795e\u7ecf\u75c5\u5b66\u4e2d\u5fc3\u9996\u5e2d\u79d1\u5b66\u5bb6\u3002\u5317\u4eac\u8111\u79d1\u5b66\u4e0e\u7c7b\u8111\u7814\u7a76\u4e2d\u5fc3\u7279\u8058\u6559\u6388\u3002\u9996\u90fd\u533b\u79d1\u5927\u5b66\u4e34\u5e8a\u8bd5\u9a8c\u4e0e\u4e34\u5e8a\u7814\u7a76\u5b66\u7cfb\u526f\u4e3b\u4efb\u3002\u517c\u4efb\u4e2d\u56fd\u5352\u4e2d\u5b66\u4f1a\u8111\u5c0f\u8840\u7ba1\u75c5\u5206\u4f1a\u526f\u4e3b\u4efb\u59d4\u5458\u3001\u4e2d\u56fd\u5352\u4e2d\u5b66\u4f1a\u9752\u5e74\u7406\u4e8b\u4f1a\u6267\u884c\u7406\u4e8b\u957f\u3001\u4e2d\u534e\u533b\u5b66\u4f1a\u795e\u7ecf\u75c5\u5b66\u5206\u4f1a\u9752\u5e74\u59d4\u5458\u4f1a\u526f\u4e3b\u4efb\u59d4\u5458\u3001\u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u795e\u7ecf\u5185\u79d1\u533b\u5e08\u5206\u4f1a\u9752\u5e74\u59d4\u5458\u4f1a\u526f\u4e3b\u4efb\u59d4\u5458\u7b49\u5b66\u672f\u4efb\u804c\u3002<\/p>\n

CSVD\u5305\u542b\u591a\u4e2a\u5f81\u8c61\uff0c\u4e0b\u56fe\u4ece\u5de6\u5230\u53f3\u4f9d\u6b21\u662f\uff1a<\/p>\n

\u8fd1\u671f\u53d1\u751f\u7684\u76ae\u5c42\u4e0b\u5c0f\u6897\u6b7b (recent
\nsmall subcortical infarcts)<\/p>\n

\u5047\u5b9a\u8840\u7ba1\u6e90\u6027\u8154\u9699 (lacune)<\/p>\n

\u8111\u767d\u8d28\u9ad8\u4fe1\u53f7 (white
\nmatter hyperintensity)<\/p>\n

\u8840\u7ba1\u5468\u56f4\u95f4\u9699 (perivascular
\nspace)<\/p>\n

\u8111\u5fae\u51fa\u8840 (cerebral
\nmicrobleed)<\/p>\n

\u8111\u76ae\u8d28\u8868\u9762\u94c1\u6c89\u79ef (cortical
\nsuperficial siderosis)<\/p>\n

\u76ae\u5c42\u8111\u5fae\u6897\u6b7b (cortical
\nmicroinfarct)<\/p>\n<\/p>\n

\u4f7f\u7528\u6700\u9891\u7e41\u7684\u63cf\u8ff0CSVD\u7684\u5f71\u50cf\u7528\u8bed<\/p>\n

\u5341\u5e74\u524d\uff0c\u9488\u5bf9\u4e0a\u56fe\u6240\u793aCSVD\u7684\u591a\u6837\u5316\u5f81\u8c61\uff0c\u63cf\u8ff0\u8fd9\u4e9b\u5f71\u50cf\u5b66\u8868\u73b0\u7684\u7528\u8bed\u4e5f\u591a\u79cd\u591a\u6837\uff0c\u8fd9\u4e0d\u5229\u4e8e\u7814\u7a76\u95f4\u7684\u5bf9\u6bd4\u3002\u4f8b\u5982\u8111\u767d\u8d28\u758f\u677e v.s \u8111\u767d\u8d28\u9ad8\u4fe1\u53f7\uff1bVR\u95f4\u9699 v.s \u8840\u7ba1\u5468\u56f4\u95f4\u9699\u7b49\u3002\u76f8\u540c\u5f81\u8c61\u7684\u7edf\u4e00\u7528\u8bed\u5bf9\u7814\u7a76\u9886\u57df\u5341\u5206\u91cd\u8981\uff0c\u5728\u8fc7\u53bb\u768410\u5e74\u4e2d\uff0cSTRIVE-1\u4e2d\u63d0\u53ca\u7684\u8111\u767d\u8d28\u9ad8\u4fe1\u53f7 (white
\nmatter hyperintensity\uff0cWMH)\u3001\u8840\u7ba1\u5468\u56f4\u95f4\u9699 (perivascular
\nspace\uff0cPVS) \u548c\u5fae\u51fa\u8840 (cerebral
\nmicrobleed\uff0cCMB) \u6210\u4e3a\u4e86\u4f7f\u7528\u7387\u6700\u9891\u7e41\u7684\u6807\u51c6\u672f\u8bed\u3002\u4e0e\u6b64\u540c\u65f6\uff0c\u5176\u4ed6\u672f\u8bed\u5982\u65b0\u53d1\u76ae\u5c42\u4e0b\u5c0f\u6897\u6b7b (recent
\nsmall subcortical infarcts\uff0cRSSI) \u3001\u8154\u9699 (lacune) \u53ca\u8111\u840e\u7f29\u4f7f\u7528\u8f83\u5c11\u3002<\/p>\n

\u65b0\u5174\u7684CSVD\u5f71\u50cf\u5b66\u8868\u73b0<\/p>\n

\u5728\u884c\u6269\u6563\u52a0\u6743\u6210\u50cf (diffusion
\nweighted imaging\uff0cDWI) \u68c0\u67e5\u65f6\uff0c\u5076\u53d1DWI\u9633\u6027\u75c5\u7076 (incident
\nDWI+ lesion) \u7684\u53d1\u751f\u6bd4\u4f8b\u9ad8\u8fbe10%\u4ee5\u4e0a\u3002\u867d\u7136\u8fd9\u4e9b\u75c5\u7076\u6ca1\u6709\u5f15\u8d77\u660e\u663e\u7684\u795e\u7ecf\u529f\u80fd\u635f\u5bb3\uff0c\u4f46\u4ecd\u53ef\u80fd\u5728\u672a\u6765\u5f15\u8d77\u8ba4\u77e5\u3001\u6b65\u6001\u7b49\u529f\u80fd\u51cf\u9000\u3002<\/p>\n

\u56e0\u6b64\uff0cSTRIVE-2\u63d0\u51fa\u5076\u53d1DWI\u9633\u6027 (DWI+) \u75c5\u7076\uff0c\u5373\uff1aDWI\u4e0a\u5076\u7136\u53d1\u73b0\u8f74\u9762\u76f4\u5f84 \u226420mm \u7684\u9ad8\u4fe1\u53f7\u75c5\u53d8(\u5982\u4e0b\u56fe)\uff0c\u53ef\u4f5c\u4e3a\u4e00\u4e2a\u65b0\u7684CSVD\u5f81\u8c61\u3002<\/p>\n<\/p>\n

\u56fe\uff1a\u5076\u53d1DWI\u9633\u6027\u75c5\u7076<\/p>\n

\u6b64\u5904\uff0cDWI\u89c2\u5bdf\u5230\u7684\u9ad8\u4fe1\u53f7\u548c\u8fd1\u671f\u53d1\u751f\u7684\u76ae\u5c42\u4e0b\u5c0f\u6897\u6b7b (recent
\nsmall subcortical infarcts\uff0cRSSI) \u6982\u5ff5\u9700\u8981\u533a\u5206\uff0c\u524d\u8005 (\u5076\u53d1DWI+) \u6ca1\u6709\u5f15\u8d77\u660e\u663e\u7684\u795e\u7ecf\u529f\u80fd\u635f\u5bb3\uff1b\u800c\u540e\u8005 (RSSI) \u662f\u4f34\u6709\u75c7\u72b6\u7684\u8111\u6897\u6b7b\u3002\u75c7\u72b6\u6027\u548c\u65e0\u75c7\u72b6\u6027\u8111\u6897\u6b7b\u4e24\u8005\u672c\u8d28\u4e0a\u662f\u4e00\u81f4\u7684\uff0c\u90fd\u4e3b\u8981\u662f\u5c0f\u52a8\u8109\u786c\u5316\u5bfc\u81f4\u7684\u3002STRIVE
\n2\u5c0f\u7ec4\u6307\u51fa\uff0c\u867d\u7136\u5076\u53d1DWI+\u7684\u76f8\u5173\u7814\u7a76\u4e00\u76f4\u975e\u5e38\u6d3b\u8dc3\uff0c\u4f46\u5728DWI+\u6b63\u5f0f\u786e\u7acb\u4e3aCSVD\u7684\u5f81\u8c61\u4e4b\u524d\uff0c\u4ecd\u9700\u8981\u63a2\u7a76\u5076\u53d1DWI+\u7684\u75c5\u56e0\u3001\u75c5\u7406\u3001\u4e34\u5e8a\u76f8\u5173\u6027\u4ee5\u53ca\u4e0eRSSI\u3001\u5fae\u6897\u6b7b\u7684\u75c5\u56e0\u75c5\u7406\u91cd\u53e0\u7b49\u95ee\u9898\u3002<\/p>\n

CSVD\u7684\u6210\u50cf\u624b\u6bb5<\/p>\n

3.0T\u7684\u78c1\u5171\u632f\u6210\u50cf\u91c7\u96c6\u5df2\u7ecf\u53d6\u4ee3\u4e861.5T\uff1b\u573a\u5f3a\u7684\u589e\u52a0\uff0c\u5c24\u5176\u662f7.0T\u78c1\u5171\u632f\u6210\u50cf\uff0c\u6539\u5584\u4e86\u5bf9\u76ae\u5c42\u5fae\u6897\u6b7b\u548c\u7a7f\u652f\u52a8\u8109\u7684\u53ef\u89c6\u5316\uff0c\u4f46\u666e\u53ca\u6027\u6709\u9650\u3002\u56fe\u50cf\u7684\u9ad8\u7a7a\u95f4\u5206\u8fa8\u7387\u5bf9\u5b9a\u91cf\u5206\u6790\u5f88\u91cd\u8981\uff0c\u5404\u5411\u540c\u60271\u6beb\u7c73\u7b49\u4f53\u7d20\u5df2\u7ecf\u6210\u4e3a\u7ed3\u6784\u50cf\u7684\u5e38\u89c1\u8bbe\u7f6e\u3002CSVD\u7684\u6838\u5fc3\u4e34\u5e8a\u91c7\u96c6\u65b9\u6848\u4ecd\u7136\u4fa7\u91cd\u4e8eT1\u52a0\u6743\u3001T2\u52a0\u6743\u3001FLAIR\u3001\u6269\u6563\u6210\u50cf\u548c\u78c1\u654f\u611f\u6210\u50cf\u3002<\/p>\n

\n

\u53c2\u8003\u8d44\u6599\uff08\u6ed1\u52a8\u67e5\u770b\u5b8c\u6574\u5185\u5bb9\uff09<\/p>\n

[1]
\nWARDLAW J M, SMITH C, DICHGANS M. Small vessel disease:mechanisms and
\nclinical implications[J]. Lancet neurology, 2019, 18(7): 684\u2013696.<\/p>\n

[2]
\nZANON ZOTIN M C, SVEIKATA L, VISWANATHAN A, et al. Cerebral small
\nvessel disease and vascular cognitive impairment: from diagnosis to
\nmanagement[J]. Current opinion in neurology, 2021, 34(2): 246\u2013257.<\/p>\n

[3]
\nDICHGANS M, LEYS D. Vascular Cognitive Impairment[J]. Circulation
\nresearch, 2017, 120(3): 573\u2013591.<\/p>\n

\u611f\u5174\u8da3\u7684\u8bfb\u8005\u53ef\u4ee5\u8fdb\u4e00\u6b65\u9605\u8bfb\u738b\u4f0a\u9f99\u6559\u6388\u5728\u56fd\u9645\u5faa\u73af\u7f51\u4e0a\u5bf9STRIVE-2\u7684\u4e2d\u6587\u89e3\u8bfb\uff1a<\/p>\n

\u8111\u5c0f\u8840\u7ba1\u75c5\uff1a\u56de\u77382022\uff08\u4e0a\uff09http:\/\/www.\/article\/NewsInfo.aspx?id=36188<\/p>\n

\u00b7END\u00b7<\/p>\n<\/p>\n

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