肾病综合征并发可逆性后头部白质脑病病例诊断分析

Diagnosis and analysis of nephrotic syndrome complicated with reversible posterior gray matter encephaiopathy

目的报道3例难治性肾病综合征在治疗过程中合并可逆性后头部白质脑病。分析患儿的临床表现，诊断治疗方法及预后的情况。探讨肾病综合征并发后部白质脑病的可能因素。方法2011～2014年间新疆维吾尔自治区人民医院儿科收治的3例难治性肾病综合征合并可逆性后头部白质脑病患儿，回顾患儿的临床表现及诊疗过程，复习国内外相关文献。结果3例难治性肾病综合征患儿均表现在治疗好转过程中出现头痛，一过性失明，抽搐等症状及精神症状，经及时积极治疗，3例患儿上述症状完全缓解，未出现其他并发症，患儿复查的头颅MR较发病时明显好转。结论可逆性后头部白质脑病可发生在难治性肾病综合征治疗恢复中的患儿，提高对本病的认识，诊断和预防该病的发生。肾病综合征可能在疾病恢复的过程中并发后部白质脑病，一旦发生，正确的诊断，积极有效的治疗对患儿的预后有重要的意义。

Objective To report the clinical feature,its treatment and follow-up of Posterior reversible encephalopathy of chil dren in nephritic syndrome,and enhance the recognition of these cases in China. Methods The clinical feature,treatment and fol low-up date of three cases of PRES of children in NP in our hospital were analyzed,and related literatures were reviewed. Results Three children of nephritic syndrome complicate PRES during better treatment. Therapy included suiting the remedy to these cases and three children came back without complication in clinic. After three week,three children couldn＇t full-recovery observing image of MR. Conclusion Children in Nephritic syndrome can complicate PRES during better treatment. Increasing recognizing of PRES and positive and effective treatment can help children came back early.