缺血性脑卒中分型、危险因素和预后的性别差异研究  

Sex differences in the subtypes,risk factors,and 12-month outcome of ischemic stroke

作　　者：周官恩[1] 安中平[1] 王景华[2] 宁宪嘉[2] 

机构地区：[1]天津市环湖医院神经内科,天津300060 [2]天津市神经病学研究所流行病学研究室,天津300060

出　　处：《中风与神经疾病杂志》2014年第7期625-627,共3页Journal of Apoplexy and Nervous Diseases

基　　金：天津市科委科技支撑计划重点项目(07ZCGYSF02800)

摘　　要：目的 探讨脑梗死患者牛津郡社区卒中项目（OCSP）临床分型和急性缺血性脑卒中Org 10172治疗实验（TOAST）病因分型、危险因素和预后的性别差异。方法 采用前瞻性队列研究,登记2007年1月~2008年5月环湖医院神经内科确诊的1019例脑梗死患者,按照性别分为男性脑梗死组和女性脑梗死组,按照OCSP标准和TOAST标准分型并进行随访,分析男性脑梗死组和女性脑梗死组预后和危险因素之间的的差异。结果 女性脑梗死组CE（心源性栓塞型）构成比高于男性脑梗死组。女性脑梗死组预后不良率为35.22%,而男性脑梗死组预后不良率为25.36%,差异有显著意义（P〈0.01）。与男性相比,女性吸烟、饮酒、同型半胱氨酸血症的发生率较低,差异有显著性意义（P〈0.01）。结论 脑梗死患者在TOAST病因分型、危险因素和预后方面存在差别。女性脑梗死组预后比男性脑梗死组更差。Objective Sex differences in stroke characteristics and outcomes have been inconsistent. We sought to determine whether sex disparities exist in TOAST and OCSP subtypes, particularly with regard to the prognosis and recur- rence in the patients with cerebral infarction in a hospital-based stroke registration study. Methods Data were collected prospectively from consecutive stroke inpatients in Huanhu Hospital from Janurary 2007 to May 2008. The patients were di- vided into two groups：male group and female group. All the patients were followed up and were classified into different sub- types according to the OCSP and TOAST criteria when they were on admission. The risk factors for ischemic stroke in all patients were assessed. Results Female patients showed a significantly lower proportion of smoking, alcohol consumption and Homocysteine and a higher proportion of atrial fibrillation. There was significant difference in CE subtype between the two groups. The percentage of worse outcome of this female group was 35.22% ,higher than the male group（25.36% ）. No significant gender effect was observed on 12-month Mortality. Conclusions Sex-specific differences exist in acute stroke. The female group has worse outcome.

关 键 词：脑梗死 性别 预后 OCSP TOAST 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]