增龄相关性脑小血管病谱系的病理基础及其影像学特点 Pathological Basis and Imaging Characteristics of Spectrum of Age-related Cerebral Small Vessel Diseases

增龄相关性脑小血管病谱系（spectrum o f a ge-related cerebral small vessel diseases， ArCSVDS）是指随着年龄的增长，脑小动脉、微动脉、毛细血管、微静脉、小静脉出现老化的一组脑 小血管病（cerebral small vessel disease，CSVD），包括深穿支动脉病（deep perforating arteriopathy，DPA） 和β淀粉样蛋白（β-amyloid，Aβ）有关的脑淀粉样血管病（cerebral amyloid angiopathy，CAA）。以往的 研究往往将这两种疾病视为独立的实体，然而最近的研究发现，无论从年龄、高血压等相似的脑血 管病危险因素，还是从潜在的相互作用角度出发，DPA与CAA是一组ArCSVDS疾病，血脑屏障（blood brain barrier，BBB）破坏、内皮细胞损伤、血管周围Aβ是连接DPA与CAA的共同发病机制，而且有 30%～68%的患者两者可以重叠发病。 Abstract: The spectrum of age-related cerebral small vessel diseases (ArCSVDS) is defined as a group of cerebral small vessel disease (CSVD) in which cerebral small arteries, arterioles, capillaries, venules, small veins appear ageing with age, and CSVD include deep perforating arteriopathy (DPA), β-amyloid (Aβ) related cerebral amyloid angiopathy (CAA). In the past, DPA and CAA were considered to be independent disease, while recent studies have found that they both belong to the ArCSVDS from the perspective of not only similar vascular risk factors and potential interac