| 摘要: |
| ［摘要］ 目的 探讨可逆性大脑后部白质脑病综合征的病因和临床特点，寻找早期诊断和治疗方法。方法 选取该院2010-02～2013-02收治的16例可逆性大脑后部白质脑病综合征患者，回顾性分析其病因、临床表现特点、治疗及预后。结果 16例患者中男6例,女10例。病因：高血压脑病7例（其中合并肾功能不全4例）,子痫4例，多发性大动脉炎2例,血栓性血小板减少性紫癜1例,系统性红斑狼疮1例，右颈内动脉内膜剥脱术后1例。临床表现以头痛、谵妄、意识障碍、癫痫发作性抽搐、视幻觉为主。头颅MRI检查可见大脑半球后部白质为主的T1加权呈短信号及T2加权呈长信号的病灶,常双侧对称。经及时适当的脱水、降颅压，改善循环和高压氧等治疗,全组16例中，症状与体征消失者14例（87.5%），明显好转者2例（12.5%）。结论 可逆性大脑后部白质脑病综合征是一种具有自身病因、临床表现特点的临床综合征，经及时有效治疗,大多预后较好。 |
| 关键词: 可逆性大脑后部白质脑病综合征 病因 临床分析 |
| DOI：10.3969/j.issn.1674-3806.2013.10.17 |
| 分类号:R 74 |
| 基金项目: |
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| Clinical analysis of 16 cases of reversible posterior leukoencephalopathy syndrome |
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MAO Zhong-chen, GAO Yuan-lin, JIA Yong-lin, et al.
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Department of Neorology-Intensive Care Unit， Kaifeng City Center Hospital,Henan 475000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the etiology and clinical features of reversible posterior leukoencephalopathy syndrome, and search for the ways of early diagnosis and treatment.Methods A retrospective analysis was performed in 16 patients with reversible posterior leukoencephalopathy syndrome treated in our hospital from February 2010 to February 2013 including the etiology, clinical characteristics, treatment and prognosis.Results There were 16 patients including 6 males and 10 females. There were 7 cases with hypertensive encephalopathy including 4 cases with renal insufficiency；4 cases with eclampsia；2 cases with multiple aortitis；1 case with thrombotic thrombocytopenic purpura；1 case with systemic lupus erythematosus and 1 case with right internal carotid artery endarterectomy. The clinical manifestations mainly included headache, delirium, consciousness disorders, seizure disorder and visual hallucinations. Brain MRI examination showed the lesions for T1-weighted short signal and T2-weighted elongated signal in the white matter of the posterior cerebral hemispheres and invariably bilateral symmetry. After appropriate dehydration, depressing the intracranial pressure,and improving circulation and hyperbaric oxygen therapy in time,in all the 16 patients,the symptoms and signs disappeared in 14 patients(accounted for 87.5%),significantly improved in 2 patients(12.5%).Conclusion The disease is a clinical syndrome with etiology and clinical characteristics. There is better prognosis for most of them by timely and effective treatment. |
| Key words: Reversible posterior leukoencephalopathy syndrome(RPLS) Etiology Clinical analysis |
