血尿酸与脑小血管病影像学改变研究进展
Journal: Basic Medical Theory Research DOI: 10.32629/bmtr.v8i2.18888
Abstract
脑小血管病（CSVD）是一组以小血管结构和功能异常为特征的异质性疾病，其影像学表现包括脑白质高信号（WMH）、脑微出血（CMB）、扩大的血管周围间隙（EPVS）等。血尿酸（UA）作为嘌呤代谢的终产物，具有抗氧化和促氧化双重特性，其水平变化与 CSVD 的发生发展密切相关。近年来，越来越多的研究表明血尿酸升高可导致CSVD，但其机制尚未完全明确。本文就尿酸与CSVD的关系及其可能的机制进行综述，旨在为患者发生CSVD的早期识别和及时诊治提供一定的参考。
Keywords
尿酸；脑小血管病；脑小血管病影像学
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[23] 李葵花,李璐,严鹏,等.不同浓度尿酸对体外红细胞流变学指标的影响[J].河北大学学报(自然科学版),2016,36(2):184-188.
[24] 唐丹萍,郑娟,杨晓蓉.血清生化指标与高尿酸血症的关系研究进展[J].实用预防医学,2025,32(3):382-385.
[25] Sha Y, Han G, Hong Y, et al. Distinct lesion features and underlying mechanisms in patients with acute multiple infarcts in multiple cerebral territories. Front Neurol. 2023 Jan 16;13:1102505.
[26] van Veluw SJ, Shih AY, Smith EE, et al. Detection, risk factors, and functional consequences of cerebral microinfarcts. Lancet Neurol. 2017 Sep;16(9):730-740.
[27] Tsujimoto K, Jo T, Nagira D, et al. The lysosomal Ragulator complex activates NLRP3 inflammasome invivo via HDAC6. EMBO J. 2023 Jan 4;42(1):e111389.
[28] 秦思宇,兰榕榆,曾佳,等.高浓度尿酸对一氧化氮的影响[J].中国医学科学院学报,2023,45(4):666-671.
[2] 朱以诚.脑小血管病影像学诊断标准的更新解读[J].中国现代神经疾病杂志,2023,23(11):955-958.
[3] Chojdak-Łukasiewicz J, Dziadkowiak E, Zimny A, et al. Cerebral small vessel disease: A review. Adv Clin Exp Med. 2021 Mar;30(3):349-356.
[4] Eliseev MS, Zheliabina OV, Nasonov EL. [Uric acid, cognitive disorders, neurodegeneration]. Ter Arkh. 2024 Jun 3;96(5):447-452.
[5] Russo E, Bertolotto M, Zanetti V, et al. Role of Uric Acid in Vascular Remodeling: Cytoskeleton Changes and Migration in VSMCs. Int J Mol Sci. 2023 Feb 3;24(3):2960.
[6] 张敬石,刘国韵,石安琪,等.脑白质高信号与主观认知下降相关性的研究进展[J].中国医学科学院学报,2025,47(1):110-117.
[7] ShihC.Y, ChenC.Y, WenC.J, et al．Relationship between serum uric acid and cerebral white matter lesions in the elderly[J]. Nutrition, metabolism, and cardiovascular diseases: NMCD,2012,22(2).
[8] Schretlen, D., et al. (2007, December 10). Barely detectable mini strokes linked to uric acid levels.Johns Hopkins Gazette.
[9] 周游.脂氧素A4对尿酸盐结晶激活NLRP3炎症小体的抑制作用与机制研究[D].兰州大学,2023.
[10] 贾杉，张琴. 血清 UA、MMP-9 水平与脑小血管病患者脑白质高信号的关系[J].脑与神经疾病杂志32,10(2024):604-608.
[11] 陈军,李君良,符家武.脑小血管病患者中血清尿酸水平与临床症状及脑白质高信号的相关性[J].广东医学,2017,38(21):3318-3320.
[12] Das AS, Abramovitz Fouks A, Gökçal E, et al. Characterizing the underlying microangiopathy of deep cerebellar intracerebral hemorrhage.J Neurol. 2025;272(2):167. Published 2025 Jan 24.
[13] Jeong S.‐M.,Yoo T.G.,Nam Y.‐S.,et al.Sex‐dependent effects of uric acid on cerebral microbleed: a cross‐sectional study in the general population[J]．European journal of neurology: the official journal of the European Federation of Neurological Societies,2017,24(10).
[14] Jin YJ, Li JW, Wu J,et al.Cortical superficial siderosis, hematoma volume,and outcomes after intracerebral hemorrhage:a mediation analysis. Front Neurol. 2023 May 5;14:1122744.
[15] Agarwal A, Ajmera P, Sharma P, et al. Cerebral microbleeds: Causes, clinical relevance, and imaging approach - A narrative review.J Neurosci Rural Pract. 2024;15(2):169-181.
[16] Koemans EA, van Etten ES. Cerebral amyloid angiopathy: one single entity?. Curr Opin Neurol. 2025;38(1):29-34.
[17] Zebarth J, Kamal R, Perlman G, et al. Perivascular spaces mediate a relationship between diabetes and other cerebral small vessel disease markers in cerebrovascular and neurodegenerative diseases.J Stroke Cerebrovasc Dis. 2023;32(9):107273.
[18] Zhang T, Lv H, Zhao X, et al. Serum uric acid is associated with midbrain enlarged perivascular spaces: Results from Multi-modality Medical imaging sTudy bAsed on KaiLuan Study (META-KLS).Prog Neuropsychopharmacol Biol Psychiatry. 2024;133:111000.
[19] Yang S,Zhang X, Yuan J, et al.Serum uric acid is independently associated with enlarged perivascular spaces. Sci Rep.(2017)7:16435.
[20] Haidegger M, Klock N, Kneihsl M, et al. Recurrent cerebrovascular events after recent small subcortical infarction.J Neurol. 2024;271(8):5055-5063.
[21] Russo E, Bertolotto M, Zanetti V, et al. Role of Uric Acid in Vascular Remodeling: Cytoskeleton Changes and Migration in VSMCs. Int J Mol Sci. 2023;24(3):2960.
[22] Del Brutto OH, Mera RM. Neuroimaging investigation of the intracranial vasculature is warranted in older adults with lacunes of presumed vascular origin. Neuroradiol J. 2022 Oct;35(5):607-611.
[23] 李葵花,李璐,严鹏,等.不同浓度尿酸对体外红细胞流变学指标的影响[J].河北大学学报(自然科学版),2016,36(2):184-188.
[24] 唐丹萍,郑娟,杨晓蓉.血清生化指标与高尿酸血症的关系研究进展[J].实用预防医学,2025,32(3):382-385.
[25] Sha Y, Han G, Hong Y, et al. Distinct lesion features and underlying mechanisms in patients with acute multiple infarcts in multiple cerebral territories. Front Neurol. 2023 Jan 16;13:1102505.
[26] van Veluw SJ, Shih AY, Smith EE, et al. Detection, risk factors, and functional consequences of cerebral microinfarcts. Lancet Neurol. 2017 Sep;16(9):730-740.
[27] Tsujimoto K, Jo T, Nagira D, et al. The lysosomal Ragulator complex activates NLRP3 inflammasome invivo via HDAC6. EMBO J. 2023 Jan 4;42(1):e111389.
[28] 秦思宇,兰榕榆,曾佳,等.高浓度尿酸对一氧化氮的影响[J].中国医学科学院学报,2023,45(4):666-671.
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