De Silva D A, Ebinger M, Davis S M
Comprehensive Stroke Centre, Royal Melbourne Hospital, Department of Neurosciences, Grattan Street, Parkville 3050, Victoria, Australia.
J Clin Neurosci. 2009 Apr;16(4):501-4. doi: 10.1016/j.jocn.2008.07.068. Epub 2009 Feb 6.
We systematically reviewed the literature to explore gender issues in acute stroke thrombolysis. The literature is inconsistent regarding the influence of gender on the timing of presentation to hospital, decision-making and utilization of acute thrombolysis among ischemic stroke patients, and hence any reported gender bias may be site-specific. Without treatment with thrombolysis, female stroke patients have a poorer clinical outcome compared to their male counterparts. Although some studies show that women have better clinical outcomes than men following intravenous thrombolysis, no gender difference is seen in others. Post-hoc analyses of relatively small studies show higher recanalisation rates in women than men following intravenous thrombolysis, and no gender difference in recanalisation rates following intra-arterial thrombolysis. Future thrombolytic trials should consider the effects of gender on both surrogate and clinical outcomes.
我们系统地回顾了文献，以探讨急性卒中溶栓治疗中的性别问题。关于性别对缺血性卒中患者到院时间、急性溶栓治疗的决策和使用的影响，文献报道并不一致，因此任何所报道的性别偏见可能因地点而异。未经溶栓治疗时，女性卒中患者的临床结局比男性患者更差。尽管一些研究表明，女性在接受静脉溶栓治疗后的临床结局优于男性，但其他研究未发现性别差异。对相对小型研究的事后分析表明，女性在接受静脉溶栓治疗后的再通率高于男性，而在接受动脉内溶栓治疗后的再通率则无性别差异。未来的溶栓试验应考虑性别对替代指标和临床结局的影响。
