目的 根据儿童高血压脑病（HE）的不同潜在病因分析其临床特征及预后。方法 回顾性分析2011年1月1日至2023年5月31日确诊的 HE患儿的临床资料。根据病因将患儿分为肾源性高血压组和非肾源性高血压组，比较两组间临床特征。结果 纳入24例HE患儿，男12例、女12例，中位年龄为9.0（7.0~12.0）岁。平均收缩压为（167.1±21.4）mmHg、收缩压指数为1.5±0.2，平均舒张压为（114.3±12.3）mmHg、舒张压指数为1.6±0.2。原发疾病以肾病综合征（3例）、狼疮性肾炎（3例）、IgA 肾病（3例）、急性淋巴细胞性白血病（3例）为主。头颅MRI异常21例（87.5%），20例患儿存在典型的可逆性后部脑病综合征（PRES）病变，1例有幕上脑积水。与非肾源性高血压组相比，肾源性高血压组年龄较大，收缩压、收缩压指数以及舒张压较高，神经症状评分较高，恶心呕吐和癫痫的发生率较高，血清总蛋白和白蛋白水平较低，差异均有统计学意义（P<0.05）。神经症状评分与年龄、收缩压和收缩压指数具有显著正相关性（P<0.01）。所有患儿的平均随访时间为（25.8±4.1）个月，1例诊断为狼疮性肾炎的患儿在HE发生后6个月内出现记忆和计算能力下降，其余23例患儿均在应用抗癫痫和高血压药物治疗后症状得到缓解，且在随访期间无异常表现。结论 肾源性高血压组患儿的临床症状比非肾源性高血压组患儿更为严重。此外，若肾源性高血压患儿突然出现癫痫发作，应高度怀疑HE，并及时进行治疗以改善预后。

Objective To analyze the clinical features and prognosis of hypertensive encephalopathy (HE) in children according to different potential causes. Methods The clinical data of children diagnosed with HE from January 1, 2011 to May 31, 2023 were retrospectively analyzed. According to the etiology, the children were divided into renal hypertension group and non-renal hypertension group, and the clinical features between the two groups were compared. Results A total of 24 children with HE (12 boys and 12 girls) were included, with a median age of 9.0 (7.0-12.0) years. The average systolic blood pressure was (167.1±21.4) mmHg, with a systolic pressure index of 1.5±0.2. The average diastolic blood pressure was (114.3±12.3) mmHg, with a diastolic pressure index of 1.6±0.2. The primary underlying diseases included nephrotic syndrome (3 cases), lupus nephritis (3 cases), IgA nephropathy (3 cases), and acute lymphoblastic leukemia (3 cases). Abnormalities on cranial MRI were observed in 21 children (87.5%), with 20 children showing typical lesions of posterior reversible encephalopathy syndrome (PRES) and 1 child exhibiting supratentorial hydrocephalus. Compared with the non-renal hypertension group, the renal hypertension group had a higher age, higher systolic blood pressure, higher systolic blood pressure index, higher diastolic blood pressure, higher neurological symptom score, higher incidence of nausea and vomiting, and higher incidence of epilepsy, as well as lower serum total protein and albumin levels, with statistically significant differences (P<0.05). The scores of neurological symptoms exhibited a significant positive correlation with age, systolic blood pressure, and systolic pressure index (P<0.01). The average follow-up duration for all children was (25.8±4.1) months. One child diagnosed with lupus nephritis experienced a decline in memory and calculation abilities within six months after the onset of HE. The remaining 23 children showed symptom relief following treatment with antiepileptic and antihypertensive medications, and no abnormal findings were noted during the follow-up period. Conclusions The clinical symptoms of children with renal hypertension are more severe than those of children with non-renal hypertension. Additionally, if children with renal hypertension experience sudden seizures, HE should be highly suspected, and timely antihypertensive treatment should be administered to improve the prognosis.