Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, 110004, Shenyang, Liaoning, People's Republic of China.
Neurol Sci. 2019 Jun;40(6):1245-1253. doi: 10.1007/s10072-019-03833-3. Epub 2019 Mar 19.
Neurological manifestations and neuroimaging abnormalities are common in patients with severe preeclampsia; however, the differences between these abnormal features occurring during early- and late-onset severe preeclampsia are unclear, and the factors associated with abnormal imaging changes in patients with neurological manifestations have not yet been fully elucidated.
A retrospective study was conducted on 172 patients with severe preeclampsia from January 2017 to June 2018 in the Department of Neurology and Obstetrics, Shengjing Hospital of China Medical University. The neurological manifestations, clinical parameters, laboratory, and neuroimaging findings were analyzed.
Early- and late-onset preeclampsia were diagnosed in 83 and 89 patients, respectively. Headache and dizziness were more common in patients with early-onset preeclampsia than in patients with late-onset preeclampsia (p = 0.013, p = 0.004, respectively). Serum uric acid, creatinine, and urea nitrogen were significantly elevated in the patients with early-onset preeclampsia (p < 0.001, p = 0.004, and p = 0.005, respectively). Neuroimaging was performed in 81 patients, of which 57 were positive. Findings indicating cerebral edema were the most common neuroimaging abnormality. Gestational weeks (p = 0.014), headache (p < 0.001), and blood urea nitrogen level (p = 0.027) may be associated with positive imaging findings. By multiple logistic regression, headache (OR = 10.2, 95% CI, 2.4-42.7; p = 0.002) proved to be an independent factor associated with neuroimaging abnormality.
Neurological symptoms such as headache and dizziness were more common in patients with early-onset preeclampsia. Renal dysfunction may also associate with early-onset severe preeclampsia. Cerebral edema was the most common neuroimaging abnormality, and headache might be independently associated with abnormal imagine changes.
严重先兆子痫患者常出现神经学表现和神经影像学异常；然而，早发型和晚发型严重先兆子痫之间这些异常特征的差异尚不清楚，且与神经学表现患者的影像学改变相关的因素尚未完全阐明。
回顾性分析 2017 年 1 月至 2018 年 6 月在中国医科大学附属盛京医院神经内科和妇产科就诊的 172 例严重先兆子痫患者的临床资料，分析其神经学表现、临床参数、实验室和神经影像学检查结果。
早发型和晚发型患者分别为 83 例和 89 例。早发型患者头痛和头晕的发生率高于晚发型患者（p=0.013，p=0.004）。早发型患者的血清尿酸、肌酐和尿素氮明显升高（p<0.001，p=0.004，p=0.005）。81 例患者进行了神经影像学检查，其中 57 例阳性。最常见的神经影像学异常为脑水肿。孕周（p=0.014）、头痛（p<0.001）和血尿素氮水平（p=0.027）与阳性影像学结果可能相关。经多因素 logistic 回归分析，头痛（OR=10.2，95%CI：2.4~42.7；p=0.002）是与神经影像学异常相关的独立因素。
早发型严重先兆子痫患者头痛和头晕等神经症状更常见。肾功能不全也可能与早发型严重先兆子痫相关。脑水肿是最常见的神经影像学异常，头痛可能与异常影像改变独立相关。
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