PDF(Pubmed)
Abstract：
Posterior reversible encephalopathy syndrome (PRES) is a rare neurological disease that may be associated with hypertension, autoregulatory failure, and the use of calcineurin inhibitors following heart transplantation (HT). In this article, we present a case series of PRES, discussing its potential causes and management strategies. Among the 126 HT recipients at our hospital, four were diagnosed with PRES. Three of these patients developed PRES within 7 days after HT. Prior to the onset of PRES, all patients experienced sustained hypertension, and strict blood pressure (BP) control was maintained. Three of the four patients recovered without PRES recurrence, while one patient died of sepsis after an episode of altered consciousness. Hypertension was observed in all patients prior to the onset of PRES, and the majority experienced symptom improvement with BP control. While most cases of PRES were reversible with conservative treatment, including the administration of antiepileptics, one irreversible case resulted in in-hospital mortality. Thus, PRES can have serious outcomes and is not invariably benign.
摘要：
后部可逆性脑病综合征（PRES）是一种罕见的神经系统疾病，可能与高血压有关，自动监管失败，心脏移植（HT）后使用钙调磷酸酶抑制剂。在这篇文章中,我们提出了一系列PRES的案例，讨论其潜在原因和管理策略。在我们医院的126名HT接受者中，其中4人被诊断为PRES。这些患者中有3人在HT后7天内出现PRES。在PRES发作之前，所有患者都经历了持续性高血压，并保持严格的血压（BP）控制。四名患者中有三名康复，没有PRES复发，而一名患者在意识改变后死于败血症。在PRES发作之前，所有患者均观察到高血压，大多数患者在血压控制下症状改善。虽然大多数PRES病例在保守治疗下是可逆的，包括抗癫痫药的管理，一例不可逆病例导致院内死亡.因此，PRES可能会产生严重的结果，并且并非总是良性的。
