可逆性后部白质脑病综合征合并HELLP综合征的临床分析  

Clinical Comparative Analysis of Reversible Posterior Leukoencephalopathy Syndrome Combined with HELLP Syndrome

作　　者：贺琳 李举 HE Lin;LI Ju(Department of Neurology,Affiliated Hospital of Xuzhou Medical University Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院神经内科,徐州江苏221000

出　　处：《反射疗法与康复医学》2025年第5期59-62,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的 探讨可逆性后部白质脑病综合征(RPLS)合并溶血、肝酶升高和血小板减少(HELLP)综合征的临床特点。方法 回顾性选取2015年6月—2024年6月徐州医科大学附属医院收治的18例RPLS合并HELLP综合征(RPLS-HELLP组)及基本资料匹配的30例未合并HELLP综合征(RPLS组)患者的一般资料、临床表现、实验室检查、影像学及围产期结局等资料。结果 两组的体质指数、孕次、早产、子痫(前期)、糖尿病、平均动脉压比较,组间差异无统计学意义(P>0.05)。抽搐为两组最常见的神经系统症状,两组比较差异无统计学意义(P>0.05)。相较于RPLS组,RPLS-HELLP组的血小板计数、PLR、血清白蛋白、血清Na+、血清总Ca2+更低,而肝酶水平更高,组间差异有统计学意义(P<0.05)。RPLS-HELLP组常见的受累脑区分别为额叶(72.22%)、顶叶(66.67%)和枕叶(44.44%),RPLS组则为顶叶(73.33%)、额叶(63.33%)和枕叶(40.00%),受累脑区间两组比较,组间差异无统计学意义(P>0.05)。RPLS-HELLP组1 min Apgar评分低于RPLS组,差异有统计学意义(P<0.05)。结论 RPLS合并HELLP综合征的母婴风险更高,凸显了及时识别并干预的重要性。Objective To investigate the clinical features of reversible posterior leukoencephalopathy syndrome(RPLS)combined with hemolysis,elevated liver enzymes,and low platelets(HELLP)syndrome.Methods The general data,clinical manifestations,laboratory examinations,imaging and perinatal outcomes of 18 patients with RPLS combined with HELLP syndrome(RPLS-HELLP group)and 30 patients without HELLP syndrome(RPLS group)matched with basic data were retrospectively selected from the Affiliated Hospital of Xuzhou Medical University from June 2015 to June 2024 and other information.Results There were no significant differences in body mass index,pregnancy time,preterm birth,preeclampsia,diabetes and mean arterial pressure between the two groups(P>0.05).Convulsion was the most common neurological symptom between the two groups,and there was no significant difference between the two groups(P>0.05).Compared with RPLS group,platelet count,PLR,serum albumin,serum Na+and serum total Ca2+in RPLS-HELLP group were lower,while liver enzyme levels were higher,and the differences between the groups were statistically significant(P<0.05).The commonly involved brain regions in RPLS-HELLP group were frontal lobe(72.22%),parietal lobe(66.67%)and occipital lobe(44.44%),while those in RPLS group were parietal lobe(73.33%),frontal lobe(63.33%)and occipital lobe(40.00%),there were no significant differences between groups(P>0.05).The 1min Apgar score of RPLS-HELLP group was lower than that of RPLS group,and the difference was statistically significant(P<0.05).Conclusion The higher risk of RPLS combined with HELLP syndrome highlights the importance of timely identification and intervention.

关 键 词：可逆性后部白质脑病综合征 溶血、肝酶升高和血小板减少综合征 临床特征 围产期结局 

分 类 号：R742[医药卫生—神经病学与精神病学]