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首页> 外文期刊>Journal of Cerebral Blood Flow and Metabolism: Official Journal of the International Society of Cerebral Blood Flow and Metabolism >Cerebral blood flow in small vessel disease: A systematic review and meta-analysis
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Cerebral blood flow in small vessel disease: A systematic review and meta-analysis

机译：小血管疾病中的脑血流：系统评价和荟萃分析

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摘要

White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that assessed cerebral blood flow in small vessel disease patients, performed meta-analysis and sensitivity analysis of potential confounders. Thirty-eight studies (n = 4006) met the inclusion criteria, including four longitudinal and 34 cross-sectional studies. Most cerebral blood flow data were from grey matter. Twenty-four cross-sectional studies (n = 1161) were meta-analysed, showing that cerebral blood flow was lower in subjects with more white matter hyperintensity, globally and in most grey and white matter regions (e.g. mean global cerebral blood flow: standardised mean difference-0.71, 95% CI -1.12, -0.30). These cerebral blood flow differences were attenuated by excluding studies in dementia or that lacked age-matching. Four longitudinal studies (n = 1079) gave differing results, e.g., more baseline white matter hyperintensity predated falling cerebral blood flow (3.9 years, n = 575); cerebral blood flow was low in regions that developed white matter hyperintensity (1.5 years, n = 40). Cerebral blood flow is lower in subjects with more white matter hyperintensity cross-sectionally, but evidence for falling cerebral blood flow predating increasing white matter hyperintensity is conflicting. Future studies should be longitudinal, obtain more white matter data, use better age-correction and stratify by clinical diagnosis.
机译：白质高信号在老年人的神经影像检查中很常见，并且是脑小血管疾病的关键特征。它们通常归因于慢性灌注不足，尽管尚不清楚是脑血流不足的原因还是作用。我们系统地回顾了评估小血管疾病患者脑血流，对潜在混杂因素进行荟萃分析和敏感性分析的研究。 38项研究（n = 4006）符合纳入标准，包括4项纵向研究和34项横断面研究。大多数脑血流数据来自灰质。对二十四项横断面研究（n = 1161）进行荟萃分析，结果表明，在白质高信号较多的受试者，全球以及大多数灰和白质区域中，脑血流量较低（例如，全球脑平均血流量：标准化平均差异-0.71，95％CI -1.12，-0.30）。这些脑血流差异因排除痴呆症研究或缺乏年龄匹配研究而减弱。四个纵向研究（n = 1079）给出了不同的结果，例如，更多的基线白质高信号在脑血流量下降之前发生（3.9年，n = 575）;在出现白质高信号的地区，脑血流量较低（1.5年，n = 40）。横断面白质高信号较多的受试者的脑血流较低，但在脑白质高信号升高之前脑血流量下降的证据却相互矛盾。未来的研究应该是纵向的，获得更多的白质数据，使用更好的年龄校正并通过临床诊断进行分层。

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