可逆性后部脑病综合征的病因、临床及影像学特点  

Etiological, clinical and imaging characters of reversible posterior encephalopathy syndrome

作　　者：郝红琳[1] 刘秀琴[1] 黄颜[1] 崔丽英[1] 张之诤 沈航[1] 倪俊[1] 李明利[2] 陈琳[1] 彭斌[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院神经内科,100730 [2]中国医学科学院北京协和医学院北京协和医院核磁室,100730

出　　处：《中华医学杂志》2009年第17期1171-1174,共4页National Medical Journal of China

摘　　要：目的了解可逆性后部脑病综合征的临床及影像学特点，探讨其病因及可能的发病机制。方法回顾性分析13例可逆性后部脑病综合征患者的基础病、临床表现、影像特点，随访了解预后。结果与可逆性后部脑病综合征相关的常见疾病有各种肾病肾功能不全、妊娠及产后子痫、结缔组织病、免疫抑制剂应用等。临床表现主要为头痛、抽搐、视力下降、精神意识改变等。影像学具有多灶性、对称性、后部为主分布的特点，累及枕、顶、额的皮质及皮质下白质病灶。一般预后较好，少数较差。结论可逆性后部脑病综合征的病因机制并不相同，病变并不都可逆，寻找病因、治疗原发病对预后有决定性意义。Objective To elucidate the clinical and imaging characters of reversible posterior encephalopathy syndrome （PRES） and to discuss the etiological factors and the probable pathogenesis. Method Retrospective analysis of basal diseases, clinical manifestations and imaging characters of 13 PRES patients was conducted with follow-ups. Results The common associated diseases are various kinds of kidney disease and renal inadequacy, eclampsia of gravidity and postpartum, connective tissue disease and immunosuppressives, et al. The main clinical manifestations are headache, convulsion, poor vision, changes of psychology or consciousness. The radiological findings are multifocal, symmetrical and posteriorly distributed in the cerebral hemispheres involving bilateral grey and white matter abnormalities in occipital, parietal and frontal regions. The majority of patients with PRES have an excellent prognosis. Conclusion The etiological factors and pathogenesis of PRES are different and not all of them are reversible. Thus it is decisive to take specific and appropriate measures.

关 键 词：可逆性后部脑病综合征 病因 磁共振成像 

分 类 号：R686[医药卫生—骨科学]