| 摘要: |
| ［摘要］ 目的 分析肾脏病患儿并发可逆性后部脑病综合征（PRES）的临床特点。方法 回顾性分析2017年8月至2024年8月电子科技大学医学院附属妇女儿童医院收治的8例肾脏疾病并发PRES患儿的临床资料。对患儿的临床表现、辅助检查结果、治疗及预后进行总结。结果 8例患儿均应用过糖皮质激素，7例应用过免疫抑制剂。临床表现主要为高血压、头痛、头晕、抽搐、意识障碍、视力障碍。头颅磁共振成像（MRI）显示病灶主要累及顶枕叶皮质及皮质下层（7例），可累及额叶（5例）、颞叶（2例）、半卵圆中心（2例）及双侧脑室（1例）。经对症治疗后，患儿临床表现及MRI检查结果均好转。截至2024年12月，8例患儿均无复发PRES。结论 肾脏病患儿可并发PRES，其发生与原发病、高血压及糖皮质激素和免疫抑制剂的应用有一定关联，头颅MRI有助于早期诊断，及时合理的治疗可将神经系统损伤降至最低。 |
| 关键词: 可逆性后部脑病综合征 肾脏疾病 儿童 磁共振成像 |
| DOI：10.3969/j.issn.1674-3806.2025.06.16 |
| 分类号:R 729 |
| 基金项目:四川省医学会科研课题（编号：2019TG08） |
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| Clinical analysis of 8 kidney disease pediatric patients complicated with posterior reversible encephalopathy syndrome |
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YANG Qin, FENG Shipin
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Posterior reversible encephalopathy syndrome(PRES)；Kidney diseases；Children；Magnetic resonance imaging(MRI)
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical features of kidney disease pediatric patients complicated with posterior reversible encephalopathy syndrome(PRES). Methods The clinical data of 8 kidney disease pediatric patients complicated with PRES who were admitted to the Affiliated Women′s and Children′s Hospital, School of Medicine, University of Electronic Science and Technology of China from August 2017 to August 2024 were retrospectively analyzed. The clinical manifestations, auxiliary examination results, treatment and prognosis of the pediatric patients were summarized. Results Glucocorticoids had been used in 8 pediatric patients, and immunosuppressants had been used in 7 pediatric patients. The main clinical manifestations of the pediatric patients were hypertension, headache, dizziness, convulsions, consciousness disorders and visual disturbances. Cranial magnetic resonance imaging(MRI) showed that the lesions mainly involved the parieto-occipital cortex and subcortex(7 cases), and possibly involved the frontal lobe(5 cases), temporal lobe(2 cases), semioval center(2 cases), and bilateral ventricles(1 case). After symptomatic treatment, both the clinical manifestations and MRI examination results of the pediatric patients improved. As of December 2024, there were no relapses of PRES in the 8 pediatric patients during the follow-up period. Conclusion The kidney disease pediatric patients can be complicated with PRES. The complicated PRES is associated with primary diseases, hypertension, and use of glucocorticoids and immunosuppressants to a certain extent in the kidney disease pediatric patients. Cranial MRI examination is helpful for early diagnosis. Timely and reasonable treatment can minimize the damage to the nervous system. |
| Key words: Posterior reversible encephalopathy syndrome(PRES) Kidney diseases Children Magnetic resonance imaging(MRI) |
