摘要
目的总结子痫前期合并可逆性后部脑病综合征的临床和影像学特点,并筛查其相关危险因素。方法共111例子痫前期患者,记录年龄、妊娠次数、收缩压、舒张压、平均动脉压、血红蛋白、血小板计数、血清肌酐和血浆D-二聚体水平,并行头部MRI检查,单因素和多因素前进法Logistic回归分析筛查子痫前期合并可逆性后部脑病综合征相关危险因素。结果 111例子痫前期患者中42例合并可逆性后部脑病综合征,Logistic回归分析显示,头痛(OR=70.958,95%CI:6.578~765.447;P=0.000)、视觉障碍(OR=3.966,95%CI:1.290~12.191;P=0.016)、收缩压(OR=1.034,95%CI:1.006~1.064;P=0.019)、血清肌酐(OR=1.060,95%CI:1.000~1.120;P=0.048)是子痫前期合并可逆性后部脑病综合征的独立危险因素。MRI显示,子痫前期合并可逆性后部脑病综合征病变位于额叶17例(40.48%)、颞叶6例(14.29%)、顶叶32例(76.19%)、枕叶35例(83.33%)、脑干4例(9.52%)、小脑7例(16.67%)以及基底节区22例(52.38%),呈T1WI低信号、T2WI和FLAIR成像高信号、扩散加权成像(DWI)高信号、表观扩散系数(ADC)低信号。结论头痛和视觉障碍、收缩压、血清肌酐水平是子痫前期合并可逆性后部脑病综合征的独立危险因素,与可逆性后部脑病综合征的发病密切相关。
Objective To analyze clinical and radiological features of preeclampsia combined withreversible posterior encephalopathy syndrome（RPES） and screen related risk factors. Methods Clinicaldata of 111 preeclampsia patients were recorded, including age, number of pregnancies, systolic bloodpressure（SBP）, diastolic blood pressure（DBP）, mean arterial pressure（MAP）, hemoglobin, blood plateletcount, serum creatinine（Cr） and plasma D-dimer. Head MRI were examined in all patients. Univariateand multivariate forward Logistic regression analysis were used to screen related risk factors of preeclampsiacombined with RPES. Results In 111 patients, 42 were combined with RPES. Logistic regressionanalysis showed headache（OR = 70.958, 95%CI： 6.578-765.447; P = 0.000）, visual disturbance（OR = 3.966,95%CI： 1.290-12.191; P = 0.016）, SBP（OR = 1.034, 95%CI： 1.006-1.064; P = 0.019） and serum Cr（OR =1.060, 95%CI： 1.000-1.123; P = 0.048） were independent risk factors of preeclampsia combined with RPES.MRI showed the lesions of preeclampsia combined with RPES were located in frontal lobe（17 cases,40.48%）, temporal lobe（6 cases, 14.29%）, parietal lobe（32 cases, 76.19%）, occipital lobe（35 cases,83.33%）, brain stem（4 cases, 9.52%）, cerebellum（7 cases, 16.67%） and basal ganglia（22 cases, 52.38%）.MRI showed T1 WI hypointensity, T2 WI and FLAIR hyperintensity, diffusion-weighted imaging（DWI）hyperintensity and apparent diffusion coefficient（ADC） hypointensity. Conclusions Headache, visualdisturbance, SBP and serum Cr level are independent risk factors of preeclampsia combined with RPES,which are closely related to the onset of RPES.
作者
白超博
董晓宇
佡剑非
BAI Chao-bo;DONG Xiao-yu;NAO Jian-fei(Department of Neurology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China)
出处
《中国现代神经疾病杂志》
CAS
北大核心
2018年第5期342-348,共7页
Chinese Journal of Contemporary Neurology and Neurosurgery
关键词
先兆子痫
后部白质脑病综合征
磁共振成像
危险因素
Pre- eclampsia
Posterior leukoencephalopathy syndrome
Magnetic resonance imaging
Risk factors
