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目的:探讨国人可逆性后部脑病综合征(RPES)的临床和影像学特征。方法:通过中国期刊全文数据库、中国科技期刊万方(维普)数据库、中国生物医学文献数据库,以2003年8月至2009年3月为限共检索有关RPES文章,共检索到39篇,剔除重复文章2篇,综述9篇,余28篇,共147例,结合温州医学院附属第一医院诊治13例,对160例RPES临床资料进行综合分析。结果:本病成人多见,女性比例偏高。继发于先兆子痫/子痫50例(31.3%),高血压脑病23例(14.4%),肾功能不全17例(10.6%),其他原因为急性肾炎、应用化疗药和细胞毒性药以及应用免疫抑制剂等。头痛、癫痫发作、意识障碍、视力障碍是RPES常见四联征。影像学表现为大脑后部对称性水肿,CT低密度灶,MRIT1低信号,T2和Flair像高信号。100例累及双侧顶叶,99例累及双侧枕叶,其他部位受累依次为额叶、小脑、颞叶、脑干、丘脑、基底节区。经过治疗,114例患者临床症状、影像学异常迅速恢复。结论:RPES是一组临床神经影像综合征。国人RPES的病因与西方人有不同(国人最多见于先兆子痫/子痫,西方人多见于使用药物后);但临床特点和影像学特点是相同。
Objective: To investigate the clinical and imaging characteristics of Chinese reversible posterior encephalopathy syndrome (RPES). Methods: A total of 39 articles were searched through the Chinese Journal Full-text Database, China Science and Technology Wanfang (VIP) Database and Chinese Biomedical Literature Database from August 2003 to March 2009, excluding 39 repetitions Article 2 articles, 9 articles, 28 articles, 147 cases in total. The clinical data of 160 cases of RPES were analyzed comprehensively with the diagnosis and treatment of 13 cases in the First Affiliated Hospital of Wenzhou Medical College. Results: The disease more common in adults, a higher proportion of women. Secondary to preeclampsia / eclampsia in 50 cases (31.3%), hypertensive encephalopathy in 23 cases (14.4%), renal insufficiency in 17 cases (10.6%), other causes of acute nephritis, the application of chemotherapy drugs and cytotoxic drugs and Application of immunosuppressive agents. Headache, seizures, disturbance of consciousness, and visual impairment are common signs of RPES. Imaging showed symmetry of the posterior cerebral edema, CT low density lesions, MRIT1 low signal, T2 and Flair high signal. 100 cases involved bilateral parietal lobe, 99 cases involved bilateral occipital lobe, followed by other parts of the frontal lobe, cerebellum, temporal lobe, brain stem, thalamus, basal ganglia. After treatment, 114 patients with clinical symptoms, imaging abnormalities quickly recovered. Conclusion: RPES is a group of clinical neuroimaging syndromes. The cause of Chinese people with RPES is different from Westerners (most people see pre-eclampsia / eclampsia, Westerners more common in the use of drugs); but the clinical features and imaging features are the same.