脑小血管病的诊治现状及未来探索之路 Diagnosis and Treatment of Cerebral Small Vessel Disease and the Way of Future Exploration

脑小血管病（cerebral small vessel disease，CSVD）是一组临床、影像、病理综合征，主要累及颅内小血管，起病隐匿。CSVD与卒中、认知下降、情感障碍、步态异常及尿便失禁密切相关，给家庭和社会带来沉重的疾病负担和经济负担。但CSVD的致病机制仍不明确，临床诊断标准不统一，临床诊疗和试验研究面临重大挑战。本文旨在汇总当前CSVD的可能病因、发病机制和临床诊疗研究的进展及局限性，展望CSVD未来可能的临床研究方向。 Abstract: Cerebral small vessel disease (CSVD) is a group of clinical, imaging and pathological syndromes mainly involving intracranial small vessels. The onset of CSVD is occult. It is closely related to stroke, cognitive decline, affective disorders, gait abnormalities and urinary and fecal incontinence. It brings heavy disease burden and economic burden to the family and society. However, the true pathogenesis of CSVD is still unclear, and the clinical diagnostic criteria are not uniform, which makes clinical diagnosis and treatment and experimental research face major challenges. The purpose of this paper is to discuss the progress and limitations of the etiology, pathogenesis, clinical diagnosis and treatment of CSVD, and to look forward to the possible clinical research direction of CSVD in the future.