可逆性后部白质脑病综合征合并HELLP综合征的临床分析

目的分析可逆性后部白质脑病综合征(PRIS)合并HELLP综合征患者的临床特征,提高对该病的认识。方法回顾性分析我院诊治1例及国内文献报道4例.PRLS合并HELLP综合征的临床表现、实验室及影像学检查、治疗和转归。结果5例患者中出现严重高血压4例,头痛5例,癫痫发作5例,视觉异常5例,意识障碍5例,精神障碍2例,局灶性神经系统定位体征3例,肢体水肿1例。实验室检查均提示有溶血、肝酶升高、血小板减少。5例患者头部cT或MRI检查均显示双侧顶枕叶白质为主的对称性异常,部分累及额叶、颞叶,病灶在cT为低密度灶,MRI为长T_1长T_2信号灶。结论 RPLS同时合并HELLP综合征是妊高征患者罕见的并发症,充分认识其临床和影像学特点,有助于及时诊断和治疗。

Clinical analysis of reversible posterior leukoencephalopathy syndrome with HELLP syndrome

Objective To investigate the clinical characteristics of reversible posterior leukoencephalopathy syndrome (RPLS) with HELLP syndrome and to improve the knowledge of this disease.Methods A retrospective study was performed on 5 cases of RPLS with HELLP syndrome (1 case from our hospital and 4 from literature in China) to analyze clinical manifestations, laboratory and imaging examinations, treatment outcomes, and prognosis. Results Four patients presented with severe hypertension, 5 patients with headache, 5 patients with epileptic seizures, 5 patients with vision disorders, 5 patients with consciousness disorders, 2 patients with mental disorders, 3 patients with focal neurological signs, and 1 patient with limb edema. The laboratory testing found hemolysis, elevated liver enzymes, and reduced platelets among all patients. The 5 patients presented with bilateral white matter abnormalities mainly located in the occipital and parietal lobes, partly invading the frontal and temporal lobes, which appeared as low density on CT images, hypointense on T₁-weighted MRI images, and hyperintense on T₂-weighted MRI images.Conclusions RPLS with HELLP syndrome is a rare complication among patients with pregnancy-induced hypertension. Understanding of the clinical and imaging characteristics will contribute to timely diagnosis and treatment of this disease.