可逆性后部脑病综合征患者临床表现及影像学分析.docVIP

可逆性后部脑病综合征患者临床表现及影像学分析 　　摘要：目的 探讨可逆性后部脑病综合征常见临床表现及影像学特点。方法 对我院2012年2月～2015年3月收治的15例可逆性后部脑病综合征患者临床表现及影像学资料，进行回顾性分析。结果 15例患者中，男性患者3例，女性患者12例；急性起病12例，占80%，亚急性起病3例，占20%；高血压患者占14例，93.33%；妊娠子痫或子子痫前期患者10例，占66.67%；尿毒症患者4例，占26.67%；白血病化疗后患者1例，占6.67%。头痛、视物模糊、癫痫发作患者各8例，占53.33%；意识状态改变及伴恶心、呕吐患者7例，占46.67%，其中有1例伴有尿失禁及肢体麻木局部神经功能损伤症状。影像学显示：累及枕叶及顶叶11例，占78.57%；累及额叶10例，占66.67%；累及基底节区8例，占53.33%；累及颞叶7例，占46.67%；另外，半卵圆中心、小脑、胼胝体、脑干均有累及。结论 本病多急性或亚急性起病，成年人女性患者居多，常见临床表现为头痛、恶心、呕吐等颅高压症状及视物模糊、癫痫发作，严重者伴意识障碍，其头颅影像学提示颅内灰白质均可累及，多以枕、顶叶受累为主；因此对于急性起病，血压过高、子痫或先兆子痫、肾功能不全、化疗药物使用患者，临床表现为头痛、视物模糊、癫痫发作患者，应及时行头颅影像学检查，警惕可逆性后部脑病综合征可能。 　　关键词：可逆性后部脑病综合征；临床表现；影像学 　　Clinical Manifestation and Imaging Analysis in Patients with Reversible Posterior Encephalopathy Syndrome 　　LIU Qi1，LI Hai-hua2 　　（1.Department of Neurology，The Affiliated Hospital of Guizhou Medical College，Guiyang 550001，Guizhou，China；2.ICU，Tumor Hospital of Guizhou Province，Guiyang 550000，Guizhou，China） 　　Abstract：Objective To investigate common clinical manifestations and imaging features of posterior reversible encephalopathy syndrome.Methods A retrospective analysis was conducted on the clinical manifestations and imaging data of 15 cases of patients with posterior reversible encephalopathy syndrome admitted in our hospital from February 2012 to March 2015.Results Among 15 patients，there were 3 cases of male patients and 12 cases of female patients；12 cases of patients with acute onset（80%）and 3 cases of patients with sub-acute onset（20%）；14 cases of patients with hypertension（93.33%）；10 cases of patients with pregnant eclampsia or pre-eclampsia（66.67%）；4 cases of patients with uremia（26.67%）；one case of patient with leukemia after chemotherapy（6.67%）；8 cases of patients with headache，blurred vision，and epileptic seizure（53.33%）；7 cases of patients with altered mental status，accompanied by nausea and vomiting（46.67%），of which one case was accompanied by symptoms of local neurological damage including urinary incontinence and numbness of limb.A