皮层扩散性抑制（cortical spreading depression，CSD）是偏头痛、脑缺血等多种神经系统疾病的关键 病理事件。最新研究表明，胶质-血管单元（glial-vascular unit，GVU）是调控CSD进程的核心结构。本综述 系统阐述了GVU各组分在CSD中的动态作用与机制：星形胶质细胞作为核心枢纽，在CSD中发挥损伤与 保护并存的双重调控作用；小胶质细胞作为CSD的起始细胞之一，参与损伤与修复的双向过程；周细胞在 CSD后出现异常收缩，介导持续性毛细血管低灌注；血管周围间隙及胶质-淋巴系统的功能改变，是影响 CSD发生与恢复的潜在因素。GVU内部各组分的协同与拮抗关系决定了疾病进程，这一认识将研究焦点 从过去的单一细胞或组分拓展至GVU这一整体，为深入理解CSD病理生理全过程及开发多靶点协同治 疗策略提供了全新视角。

Cortical spreading depression (CSD) is a key pathological event in various neurological disorders such as migraine and cerebral ischemia. Recent research reveals that the glial-vascular unit (GVU) serves as a central platform regulating the CSD process. This review systematically elucidates the dynamic roles and mechanisms of GVU components in CSD: the dual functions of astrocytes as central hubs; microglia acting as one of initiating cells potentially involved in both damaging and reparative effects; abnormal post-CSD contraction of pericytes mediating sustained capillary hypoperfusion; while functional alterations in the perivascular space and glymphatic system may represent potential factors influencing CSD initiation and recovery. These findings establish the GVU as the core regulatory platform for CSD, whose internal synergy and conflicts determine disease progression. This shifts the research focus from individual components to the entire GVU, providing novel perspectives for comprehensively understanding CSD pathophysiology and developing multi-target synergistic therapeutic strategies.