摘要
血管衰老是指血管在生理和病理状态下逐渐失去功能和结构完整性的过程,是人体各器官系统衰老、增龄性血管疾病的生理病理基础。随着全球人口老龄化加剧,血管衰老已成为影响心血管健康的重要因素。血管衰老其机制涉及内皮功能障碍、平滑肌细胞表型转化及细胞外基质重构的级联互作,其中慢性炎症和氧化应激发挥重要作用。临床评估方面,脉搏波传导速度、血流介导舒张功能及影像学技术实现了血管功能与结构的无创量化,但生物标志物特异性不足与多模态评估标准化仍是瓶颈。干预策略中,传统药物(血管紧张素转换酶抑制剂、他汀等)和生活方式干预(热量限制、运动)均可通过多靶点调控延缓血管衰老进程,新兴疗法如senolytics和干细胞治疗展现出应用前景。未来研究需整合跨学科研究,共同推动《血管衰老临床评估与干预中国专家共识(2024版)》的实践转化。
Vascular aging refers to the progressive decline in functional and structural integrity of blood vessels under physiological and pathological conditions,serving as the pathophysiological basis for systemic organ aging and age-related vascular diseases.With the acceleration of global population aging,vascular aging has emerged as a critical determinant of cardiovascular health.Its mechanisms involve cascade interactions among endothelial dysfunction,phenotypic switching of vascular smooth muscle cells,and extracellular matrix remodeling,with chronic inflammation and oxidative stress playing pivotal roles.Clinically,noninvasive quantification of vascular function and structure has been achieved through pulse wave velocity,flow-mediated dilation,and imaging modalities(ultrasound,CT/MRI),yet challenges persist regarding insufficient specificity of biomarkers and standardization of multimodal assessments.Among intervention strategies,conventional pharmacological agents(e.g.,ACE inhibitors,statins)and lifestyle modifications(caloric restriction,exercise)delay vascular aging via multi-target regulatory mechanisms,while emerging therapies such as senolytics and stem cell-based therapies demonstrate promising therapeutic potential.Future research should prioritize the integration of interdisciplinary approaches to advance the clinical translation of the Chinese expert consensus on clinical assessment and intervention of vascular aging(2024 edition).
作者
张乐
张存泰
Zhang Le;Zhang Cuntai(Department of Geriatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,1095 Jiefang Avenue,Wuhan 430030,China;Key Laboratory of Vascular Aging,Ministry of Education,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,1095 Jiefang Avenue,Wuhan 430030,China)
出处
《中华老年医学杂志》
北大核心
2025年第8期1031-1039,共9页
Chinese Journal of Geriatrics
基金
国自然区域创新发展联合基金(U24A20741)
湖北省技术创新重大科技项目(2022BCA001)
深圳市医学研究专项(C2406001)
国家重点研发计划(2023YFC3605100)
湖北省自然科学基金面上项目(2023AFB685)。
关键词
衰老
血管疾病
临床评估和干预
专家共识
血管衰老的标准化评估和干预
Aging
Vascular diseases
Clinical assessment and intervention
Expert consensus
Standardized assessment and intervention in vascular aging
