Leslie-Mazwi Thabele M, Brott Thomas G, Brown Robert D, Worrall Bradford B, Silliman Scott L, Case L Douglas, Frankel Michael R, Rich Stephen S, Meschia James F
Department of Neurology, Mayo Clinic, Jacksonville, Florida 32224, USA.
J Stroke Cerebrovasc Dis. 2007 Sep-Oct;16(5):187-93. doi: 10.1016/j.jstrokecerebrovasdis.2007.03.004.
Epidemiologic studies suggest sex differences in evaluation of patients presenting with ischemic stroke. Sex differences in stroke evaluation could lead to sex differences in the validity of diagnosing ischemic stroke subtypes. This study assessed sex differences in the Ischemic Stroke Genetics Study (ISGS).
The ISGS is a prospective case-control genetic association study of patients with first-ever ischemic stroke at 5 US tertiary stroke centers. The diagnostic tests performed as part of medical care were recorded for each enrolled patient.
A total of 505 patients were enrolled; 45% (229 of 505) were women and 55% (276 of 505) were men. Mean age at time of stroke was greater for women (66.6 v 61.9 years; P = .001). Frequency of brain computed tomography was 92% (254 of 276) for men and 90% (206 of 229) for women (P = .42). Magnetic resonance imaging was completed in 84% (232 of 276) of men and 83% (191 of 229) of women (P = .91). Frequency of electrocardiography was 91% (252 of 276) for men and 90% (206 of 229) for women (P = .60). Echocardiography was done in 74% (203 of 276) of men and 79% (180 of 229) of women (P = .19). Cervical arterial imaging occurred in 91% (208 of 229) of women and 86% (237 of 276) of men (P = .09). Intracranial vascular imaging was performed in 75% (207 of 276) of men and 79% (181 of 229) of women (P = .28).
Our findings suggest no significant sex differences in the extent to which major diagnostic tests were performed in patients in ISGS. Dedicated tertiary stroke centers may reduce the sex bias in stroke evaluation that has been identified by previous studies.
流行病学研究表明，在对缺血性中风患者的评估中存在性别差异。中风评估中的性别差异可能导致缺血性中风亚型诊断有效性的性别差异。本研究评估了缺血性中风遗传学研究（ISGS）中的性别差异。
ISGS是一项在美国5个三级中风中心对首次发生缺血性中风患者进行的前瞻性病例对照基因关联研究。记录了每位入选患者作为医疗护理一部分所进行的诊断测试。
共入选505例患者；45%（505例中的229例）为女性，55%（505例中的276例）为男性。女性中风时的平均年龄更大（66.6岁对61.9岁；P = 0.001）。男性脑部计算机断层扫描的频率为92%（276例中的254例），女性为90%（229例中的206例）（P = 0.42）。84%（276例中的232例）的男性和83%（229例中的191例）的女性完成了磁共振成像（P = 0.91）。男性心电图检查的频率为91%（276例中的252例），女性为90%（229例中的206例）（P = 0.60）。74%（276例中的203例）的男性和79%（229例中的180例）的女性进行了超声心动图检查（P = 0.19）。91%（229例中的208例）的女性和86%（276例中的237例）的男性进行了颈动脉成像（P = 0.09）。75%（276例中的207例）的男性和79%（229例中的181例）的女性进行了颅内血管成像（P = 0.28）。
我们的研究结果表明，在ISGS患者中，主要诊断测试的执行程度不存在显著的性别差异。专门的三级中风中心可能会减少先前研究中发现的中风评估中的性别偏见。
