血管认知障碍和痴呆症:临床特征,神经病理学和生物标志物
Perminder S Sachdev1, Adam C Bentvelzen2, Deborah Gustafson3
1Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Journal of the American College of Cardiology
|January 7, 2026
概括
血管认知障碍和痴呆症 (VCID) 是第二常见的痴呆症. 心血管临床医生在识别和管理VCID方面发挥着关键作用,VCID与脑血管疾病有关,并与阿尔茨海默病共享风险因素.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 老年病的医生 老年病的医生
背景情况:
- 血管认知障碍和痴呆症 (VCID) 是第二常见的痴呆症,占病例的15-20%.
- 大脑血管疾病 (CeVD) 在高达75%的病例中导致痴呆,并且经常与阿尔茨海默氏症 (AD) 一起发生.
- CeVD和心血管疾病之间的共同风险因素需要心血管临床医师参与VCID管理.
研究的目的:
- 描述VCID的临床特征,病理生理学和生物标志物.
- 突出心血管临床医生在早期识别,管理和预防VCID中的关键作用.
- 提供VCID诊断标准和治疗的最新进展的概述.
主要方法:
- 诊断包括识别认知综合征,然后确定血管病因.
- 临床病史,检查和神经成像 (最好是MRI) 用于诊断.
- 支持诊断的MRI发现包括心脏病发作,白质超强度和微型出血.
主要成果:
- VCID具有不同的临床特征,包括急性发病,逐步下降或逐渐进展.
- 认知缺陷涉及信息处理速度,注意力,执行功能和情绪不稳定性.
- 诸如心房动和心力衰竭等心脏疾病被确定为VCID风险因素.
结论:
- 心血管临床医生对于早期VCID检测和干预至关重要.
- 了解共同的风险因素和病理生理学有助于预防心血管疾病和VCID.
- 诊断标准和生物标志物的进步正在改善VCID管理.
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