脑淀粉样血管病（cerebral amyloid angiopathy，CAA）是老年人中常见的脑小血管疾病，其特征为β淀 粉样蛋白（amyloid β, Aβ）在软脑膜及皮质小血管壁的异常沉积。尽管在CAA患者及动物模型的脑小静脉 中已观察到Aβ沉积，现有研究仍主要聚焦于动脉与毛细血管层面的病理改变，而对静脉的关注相对不足。 近年来，随着研究的深入，静脉在阿尔茨海默病及其他脑小血管疾病中的潜在病理作用逐渐受到重视。然 而，关于静脉在CAA发生与发展中的具体机制仍不清楚。为此，本综述将从静脉角度系统探讨CAA的临 床表现与潜在病理机制，以期为该病的早期临床干预提供新的思路。

Cerebral amyloid angiopathy (CAA) is a common cerebral small vessel disease in the elderly, characterized primarily by the deposition of amyloid β (Aβ) in the leptomeninges and small vessels of the cortex. Although the presence of Aβ has been confirmed in the venules of both CAA patients and animal models, current research on CAA mainly focuses on the deposition of Aβ in arteries and capillaries, with relatively little attention given to veins. Recently, as research has advanced, the potential pathological role of veins in Alzheimer’s disease and cerebral small vessel diseases has gradually gained recognition. However, the pathological mechanisms by which veins contribute to the formation and progression of CAA remain unclear. Therefore, this review will provide an in-depth analysis of the clinical manifestations and potential pathological mechanisms of CAA from the perspective of veins, aiming to offer new insights for early clinical intervention in CAA.