CAJ | 학술논문

目的探讨可逆性后部脑病综合征(PRES)患者血清乳酸脱氢酶(LDH)与 MRI 表现(脑水肿程度、类型)的关系.资料与方法纳入有典型临床症状和MRI 表现的35例 PRES 患者,由2位神经放射医师评价脑水肿程度,综合分析液体衰减反转恢复(FLAIR)像、扩散加权成像(DWI)和表观扩散系数(ADC)图,判断水肿类型,分析脑水肿程度及类型与 LDH 水平的相关性.结果子痫患者LDH 水平[(536.9±252.4)IU/L]显著高于非子痫患者[340.7±117.4)IU/L](P<0.05).有脑深部结构累及的患者 LDH 水平[(492.4±215.9)IU/L]显著高于无脑深部结构累及的患者[(355.7±205.8)IU/L)](P<0.05).有、无细胞毒性水肿患者之间血清LDH 水平[(522.0±241.5)IU/L、(388.0±191.2)IU/L]差异无统计学意义(P>0.05).LDH 水平与脑水肿分布评分呈中度正相关(r=0.65, P<0.01).结论脑水肿程度可能反映患者炎症的严重程度,血清 LDH 水平可作为 PRES 患者脑水肿程度的预测指标.
목적탐토가역성후부뇌병종합정(PRES)환자혈청유산탈경매(LDH)여 MRI 표현(뇌수종정도、류형)적관계.자료여방법납입유전형림상증상화MRI 표현적35례 PRES 환자,유2위신경방사의사평개뇌수종정도,종합분석액체쇠감반전회복(FLAIR)상、확산가권성상(DWI)화표관확산계수(ADC)도,판단수종류형,분석뇌수종정도급류형여 LDH 수평적상관성.결과자간환자LDH 수평[(536.9±252.4)IU/L]현저고우비자간환자[340.7±117.4)IU/L](P<0.05).유뇌심부결구루급적환자 LDH 수평[(492.4±215.9)IU/L]현저고우무뇌심부결구루급적환자[(355.7±205.8)IU/L)](P<0.05).유、무세포독성수종환자지간혈청LDH 수평[(522.0±241.5)IU/L、(388.0±191.2)IU/L]차이무통계학의의(P>0.05).LDH 수평여뇌수종분포평분정중도정상관(r=0.65, P<0.01).결론뇌수종정도가능반영환자염증적엄중정도,혈청 LDH 수평가작위 PRES 환자뇌수종정도적예측지표.
Purpose To determine the relationship between MRI features (degree and type of edema) of posterior reversible encephalopathy syndrome (PRES) and level of serum lactate dehydrogenase (LDH). Material and Methods Thirty-five patients with typical clinical symptoms and characteristic MRI findings of PRES were included in this study. The extent and distribution of brain edema were graded by two observers blinded to patients' clinical information. The level of serum LDH was correlated with the degree and type of edema determined on FLAIR, DWI and ADC map. Results There were statistical significances of serum LDH level between eclamptic and non-eclamptic patients [(536.9±252.4) IU/L vs. (340.7±117.4) IU/L, P<0.05], and between patients with and without deep structures involved [(492.4±215.9) IU/L vs. (355.7±205.8) IU/L, P<0.05]. Serum LDH level of patients with cytotoxic or vasogenic edema showed no statistical difference [(522.0±241.5) IU/L vs. (388.0±191.2) IU/L, P>0.05]. The level of serum LDH was significantly correlated with brain edema (r=0.65, P<0.01). Conclusion Increased serum LDH level, which plays an essential role in endothelial injury, may be a potential risk factor for the development of edema in PRES.