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脑小血管病（cerebral small vessel disease，CSVD）是临床上常见的一类与年龄相关的脑血管 疾病。脑白质高信号（white matter hypertensities，WMH）是CSVD的影像标志物之一。WMH患病率极高， 与认知障碍的发生发展密切相关，但其影像表现及临床症状的异质性为早期发现、早期诊断带来了 困难。本文从病理学、影像学及生物学3方面对WMH发生发展及其导致认知障碍的机制研究现况进 行综述，同时总结目前的治疗策略，提出了接下来的研究目标及方向：能够反映预后的标志物及预测 模型的研究，WMH发生发展的病理生理学机制研究，针对早期干预、药物开发的潜在靶点的研究等。 Abstract: Cerebral small vascular disease (CSVD) is one of the most common age-related cerebrovascular diseases. White matter hyperintensity (WMH) of presumed vascular origin is one of the imaging markers of CSVD. The prevalence of WMH is extremely high, and which is closely related to the occurrence and development of cognitive impairment. However, the heterogeneity of imaging manifestations and clinical symptoms of WMH brings some difficulties to early detection and diagnosis. What’s more, the potential mechanism for disease development is not clear, so it leads to a relative lag in prevention and treatment of these diseases. This paper reviewed the current state of research on the mechanisms of cognitive impairment in the development of WMH from pathology, imaging and biology, and summarized the current treatment strategies, and raised some research objectives and directions in the next, for example, to establish the biomarkers and prediction model for assessing prognosis, to explore pathophysiological mechanism of WMH development, and find new potential targets for early intervention.