摘要目的探讨合并后部可逆性脑病综合征（PRES）的子痫前期（PE）孕妇头颅MRI表现与血清胎盘生长因子（PlGF）、可溶性内皮糖蛋白（sEng）水平的关系。方法选取广东省妇幼保健院和广州医科大学附属第三医院自2013年9月至2014年3月收治的34例单胎妊娠PE孕妇，根据头颅MRI表现分为PRES组（13例）和头颅MRI正常组（21例），均行常规头颅MRI检查及弥散成像技术（DWI）扫描，计算脑水肿评分（SBE）。ELISA法检测两组PE孕妇的血清PlGF、sEng的水平，比较两组血清PlGF、sEng水平及sEng/PlGF比值的差异；评估sEng/PlGF比值对PRES诊断的价值及其与SBE的相关性。结果 PRES组PE孕妇的血清PlGF水平为（231±67）ng/L，头颅MRI正常组为（334±38）ng/L，两组相比，差异有统计学意义（t=5.6，P<0.05）；PRES组PE孕妇的sEng水平为（5256±880）ng/L，头颅MRI正常组为（3956±538）ng/L，两组相比，差异有统计学意义（t=6.53，P<0.01）；PRES组PE孕妇sEng/PlGF比值为（23±10），头颅MRI正常组为（12±2），两组相比，差异有统计学意义（t=8.4，P<0.01）。sEng/PlGF比值诊断PRES的受试者工作特征曲线下面积为0.85（P<0.01），界值为20.0，敏感度为81.8%，特异为85.0%。PlGF、sEng水平与SBE无相关（P均>0.05），sEng/PlGF比值与SBE呈正相关性（r=0.81，P<0.01）。结论 PE孕妇血清sEng/PlGF比值与脑水肿程度相关，sEng/PlGF比值可作为PRES预测的参考指标。

abstractsObjective To investigate the MRI characteristics of posterior reversible encephalopathy syndrome (PRES) in patients with pre-eclampsia(PE) and its correlation with serum placental growth factor (PlGF),soluble endoglin (sEng) and sEng/PlGF ratio. Methods 34 patients with PE who were admitted to Guangdong Women and Children Hospital from September 2013 to March 2014 were studied retrospectively.13 cases had PRES and 21 cases had normal cerebral MRI. All patients underwent conventional MRI and DWI scanning. The score of brain edema (SBE) were calculated. PlGF,sEng concentrations were measured with ELISA. The levels of PlGF, sEng and sEng/PlGF were compared between the PRES group and the normal MRI groups. The correlation of sEng/PIGF ratio and SBE were studied as well. Results The PlGF in the PRSE group was(231.4±66.8)ng/L,and in normal cerebral MRI group was (333.6 ± 37.5)ng/L (t=5.61, P<0.05). The sEng in the PRSE group was(5 256.2 ± 879.6)ng/L, in normal cerebral MRI group was(3 955.6 ± 537.7)ng/L (t=6.53, P<0.01).The sEng/PlGF in the PRSE group was&nbsp;(26.0±10.0),and in normal cerebral MRI group was(11.9±1.6;t=8.41, P<0.01), with the cut-off value of 20.0. The sensitivity was 81.8% and the specificity was 85.0%.There was no statistically significant correlation between PlGF, sEng and SBE (P>0.05).There was a positive correlation between the sEng/PlGF ratio and SBE (P>0.05).Conclusion The value of sEng/PlGF ratio was correlated with brain edema score in PE. The serum sEng/PlGF ratio may be used as a reference for prediction of PRES.