不同性别特发性颅内高压患者的临床特征差异  

Differences in Clinical Characteristics of Patients with IdiopathicIntracranial Hypertension of Different Genders

作　　者：张晓[1] 田田[1] ZHANG Xiao;TIAN Tian(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经内科,河南郑州450052

出　　处：《河南医学研究》2022年第11期1946-1950,共5页Henan Medical Research

基　　金：国家自然科学基金资助项目(U1804171)。

摘　　要：目的评估不同性别的特发性颅内高压(IIH)患者的临床特征差异。方法回顾性分析2013年1月至2021年7月郑州大学第一附属医院收治的IIH患者临床资料,按性别对患者进行分组。比较发病年龄、危险因素、体质量指数(BMI)、颅内压水平、影像学特征及视力预后等临床特征。结果纳入54例男性患者和145例女性患者,男性IIH患者常表现为头痛,且BMI值较女性高,更可能患有阻塞性睡眠呼吸暂停症和高血压(P<0.05)。女性IIH患者常表现为视物模糊,平均颅内压水平较男性IIH者高,更常伴贫血及视乳头水肿(P<0.05)。影像学特征方面,女性IIH患者中静脉窦狭窄、空蝶鞍、视神经突出及眼球后缘平坦者比率更高,且女性患者视力下降程度更大,预后较差(P<0.05)。结论男性和女性IIH患者有不同的临床特征,这可能是不同性别间的症状阈值差异。女性IIH患者发生严重视力丧失的可能性是男性的2.106倍,因此需要更积极的干预措施,更密切地对其视觉功能进行随访。Objective To evaluate the differences in the clinical characteristics of idiopathic intracranial hypertension(IIH)patients of different genders.Methods By retrospectively analyzing the clinical data of IIH patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to July 2021,and they were grouped by gender.The clinical characteristics such as age at onset,risk factors,body mass index(BMI),intracranial pressure level,imaging characteristics and visual prognosis were compared.Results Fifty-four male and 145 female patients were included,and male IIH patients often presented with headache and had a higher BMI than females,who were more likely to have obstructive sleep apnea and hypertension(P<0.05).Female IIH patients often showed blurred vision,with higher mean intracranial pressure levels than male IIH patients,more often with anemia and papilledema(P<0.05).In terms of imaging features,the proportion of female patients IIH had a higher proportion of venous sinus stenosis,empty sella,optic nerve protrusion and flat posterior edge of eyeball,and female patients had greater visual acuity decline and poorer prognosis(P<0.05).Conclusion Male and female patients with IIH have different clinical characteristics,which may be due to differences in symptom thresholds between genders.Female IIH patients were 2.106 times more likely to have severe visual loss than males,thus requiring more aggressive interventions and closer follow-up of their visual function.

关 键 词：特发性颅内高压 性别 合并症 影像学指标 视力 

分 类 号：R741[医药卫生—神经病学与精神病学]