Arboix Adrià, Milian Manel, Oliveres Montserrat, García-Eroles Luís, Massons Juan
Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, University of Barcelona, Barcelona, Spain.
Eur Neurol. 2006;56(1):6-12. doi: 10.1159/000094249. Epub 2006 Jun 27.
This study assessed gender differences in diabetic patients with ischemic stroke with respect to vascular risk factors, clinical features and early outcome. Ischemic stroke was diagnosed in 261 diabetic women and 300 diabetic men of 2,446 ischemic stroke patients included in a prospective stroke registry over 17 years. Mean +/- SD age was 77.5 +/- 8.3 years in women and 71.8 +/- 9.7 years in men (p < 0.021). Risk factors for stroke including hypertension, atrial fibrillation, congestive heart failure and valvular heart disease were significantly more common in women. Cardioembolic infarction occurred in 29.5% of women and 15.3% of men (p < 0.001), and lacunar stroke in 40.3% of men and 29.9% of women (p < 0.006). In-hospital mortality was 14.9% in diabetic women, and 8.3% in diabetic men (p < 0.02). After multivariate analysis, congestive heart failure (OR = 4.59), frontal lobe involvement (OR = 2.67), hypertension (OR = 1.62) and age were independent variables for ischemic stroke in diabetic women. Diabetic women had a poor prognosis, which may be due to differences in age, comorbidity and stroke subtype distribution.
本研究评估了缺血性脑卒中糖尿病患者在血管危险因素、临床特征和早期预后方面的性别差异。在一项为期17年的前瞻性卒中登记研究纳入的2446例缺血性脑卒中患者中，诊断出261例糖尿病女性和300例糖尿病男性患有缺血性脑卒中。女性的平均年龄±标准差为77.5±8.3岁，男性为71.8±9.7岁（p<0.021）。包括高血压、心房颤动、充血性心力衰竭和瓣膜性心脏病在内的脑卒中危险因素在女性中明显更为常见。心源性脑梗死在29.5%的女性和15.3%的男性中发生（p<0.001），腔隙性卒中在40.3%的男性和29.9%的女性中发生（p<0.006）。糖尿病女性的住院死亡率为14.9%，糖尿病男性为8.3%（p<0.02）。多变量分析后，充血性心力衰竭（OR=4.59）、额叶受累（OR=2.67）、高血压（OR=1.62）和年龄是糖尿病女性缺血性脑卒中的独立变量。糖尿病女性预后较差，这可能是由于年龄、合并症和卒中亚型分布的差异所致。
