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Neurology：急性低血压可以加速CADASIL病理进展！

2017-02-16 xing.T MedSci原创

急性低血压CADASIL
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研究结果表明急性低血压的血管反应性受损可以加速CADASIL病理进展。此外，受影响白质区域的静脉胶原病在维护白质完整性上发挥了重要作用，虽然在很大程度上被忽视。

近日，神经病学领域权威取杂志Neurology上发表了一篇研究文章，研究人员旨在强调血压调控在常染色体显性遗传性脑动脉病伴皮质下梗死和白质脑病（CADASIL）的重要性并且进一步描述这种疾病静脉发生的变化，特别是静脉胶原病相关的脑白质疏松。

研究人员报道了CADASIL患者的神经影像学及病理资料。

研究人员分析了一名61岁的男性，其基因检查证实了CADASIL诊断，在遭遇交通事故后最初清醒，但随后出现低血压（60/40mmHg），由于出现了开放性股骨骨折，需要插管。多个新发白质梗死出现在脑成像资料上。第二次低血压发生在几天之后，与新发的双侧放射冠和小脑脚硬币大小的梗死相关，并且导致四肢瘫痪。在心脏或血管成像资料中没有找到栓子的来源。该患者在外伤后5周死亡。尸检结果显示广泛的皮层下和脑室周围白质脑病以及深部皮层下灰质和白质多发空洞。小动脉壁增厚，肌层紊乱，内膜周围有希夫酸（PAS）阳性物质。脑室周围扩大，并且小口径静脉壁增厚，PAS染色阴性，符合静脉胶原病诊断。有没有整体缺氧或弥漫性轴索损伤的病理证据。

研究结果表明急性低血压的血管反应性受损可以加速CADASIL病理进展。此外，受影响白质区域的静脉胶原病在维护白质完整性上发挥了重要作用，虽然在很大程度上被忽视。

原始出处：

Jacqueline A. Pettersen,et al. CADASIL accelerated by acute hypotension Arterial and venous contribution to leukoaraiosis. Neurology.   http://dx.doi.org/10.1212/WNL.0000000000003717

本文系梅斯医学（MedSci）原创编译整理，转载需授权！

评论区 (5)
#插入话题
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    2017-12-30 sunmin0231

    #CADASIL#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1752028, encodeId=23d81e52028b2, content=<a href='/topic/show?id=15ba396ece' target=_blank style='color:#2F92EE;'>#CADASIL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=160, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3967, encryptionId=15ba396ece, topicName=CADASIL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e99536423166, createdName=sunmin0231, createdTime=Sat Dec 30 05:48:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999832, encodeId=746d19998323b, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 08 23:48:00 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264613, encodeId=dfe41264613c2, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367340, encodeId=0e6c136e34061, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176582, encodeId=ab4b1e65826d, content=学习知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Fri Feb 17 09:42:14 CST 2017, time=2017-02-17, status=1, ipAttribution=)]
    2017-07-08 yinhl1978

    #Neurol#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1752028, encodeId=23d81e52028b2, content=<a href='/topic/show?id=15ba396ece' target=_blank style='color:#2F92EE;'>#CADASIL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=160, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3967, encryptionId=15ba396ece, topicName=CADASIL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e99536423166, createdName=sunmin0231, createdTime=Sat Dec 30 05:48:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999832, encodeId=746d19998323b, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 08 23:48:00 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264613, encodeId=dfe41264613c2, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367340, encodeId=0e6c136e34061, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176582, encodeId=ab4b1e65826d, content=学习知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Fri Feb 17 09:42:14 CST 2017, time=2017-02-17, status=1, ipAttribution=)]
    2017-02-18 般若傻瓜

    #ADA#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1752028, encodeId=23d81e52028b2, content=<a href='/topic/show?id=15ba396ece' target=_blank style='color:#2F92EE;'>#CADASIL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=160, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3967, encryptionId=15ba396ece, topicName=CADASIL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e99536423166, createdName=sunmin0231, createdTime=Sat Dec 30 05:48:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999832, encodeId=746d19998323b, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 08 23:48:00 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264613, encodeId=dfe41264613c2, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367340, encodeId=0e6c136e34061, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176582, encodeId=ab4b1e65826d, content=学习知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Fri Feb 17 09:42:14 CST 2017, time=2017-02-17, status=1, ipAttribution=)]
    2017-02-18 chentianping

    #低血压#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1752028, encodeId=23d81e52028b2, content=<a href='/topic/show?id=15ba396ece' target=_blank style='color:#2F92EE;'>#CADASIL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=160, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3967, encryptionId=15ba396ece, topicName=CADASIL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e99536423166, createdName=sunmin0231, createdTime=Sat Dec 30 05:48:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999832, encodeId=746d19998323b, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 08 23:48:00 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264613, encodeId=dfe41264613c2, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367340, encodeId=0e6c136e34061, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Feb 18 06:48:00 CST 2017, time=2017-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176582, encodeId=ab4b1e65826d, content=学习知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Fri Feb 17 09:42:14 CST 2017, time=2017-02-17, status=1, ipAttribution=)]
    2017-02-17 flysky120

    学习知识了

    0