Jovanović D R, Beslać-Bumbasirević Lj, Budimkić M, Pekmezović T, Zivković M, Kostić V S
Institute of Neurology, School of Medicine, Clinical Centre of Serbia, 11000 Belgrade, Serbia.
Clin Neurol Neurosurg. 2009 Nov;111(9):729-32. doi: 10.1016/j.clineuro.2009.06.014. Epub 2009 Aug 3.
The female sex is associated with increased stroke severity and relatively poor functional recovery. Several studies have demonstrated that women with stroke benefit more from intravenous thrombolysis compared with men, while others found the nullification of gender effect among women treated with recombinant tissue plasminogen activator (rtPA). The purpose of our study was to determine any gender differences in the efficacy and safety of systemic thrombolysis among patients with acute ischemic stroke in Serbia.
Data were from the Serbian experience with intravenous thrombolysis in ischemic stroke (SETIS) study, a prospective, ongoing, multicenter, open, and observational study in Serbia of all patients who have received rtPA for acute ischemic stroke. We analyzed sex differences in the baseline characteristics, functional outcome and treatment complications.
Among 60 women and 96 men with stroke and treated with intravenous thrombolysis, we found that at day 90, no significant sex differences in excellent functional outcome (50.9% of women vs. 57.0% of men, p=0.5), favorable functional outcome (61.4% of women vs. 68.8% of men, p=0.38) or death (8.8% of women vs. 12.9% of men, p=0.60). These results were constant even after adjustments for age, severity of basal neurological deficit and onset to treatment time.
There were no sex differences in functional outcome at 90 days after the stroke among patients treated with IV rtPA. This finding might confirm that thrombolytic therapy nullifies usual sex differences in stroke outcome and suggests that women with stroke may benefit more from rtPA treatment.
女性与中风严重程度增加及功能恢复相对较差有关。多项研究表明，与男性相比，中风女性从静脉溶栓中获益更多，而其他研究发现，接受重组组织型纤溶酶原激活剂（rtPA）治疗的女性中不存在性别效应。我们研究的目的是确定塞尔维亚急性缺血性中风患者全身溶栓疗效和安全性方面的性别差异。
数据来自塞尔维亚缺血性中风静脉溶栓经验（SETIS）研究，这是一项在塞尔维亚进行的前瞻性、正在进行的、多中心、开放的观察性研究，纳入了所有接受rtPA治疗急性缺血性中风的患者。我们分析了基线特征、功能结局和治疗并发症方面的性别差异。
在60名接受静脉溶栓治疗的中风女性和96名中风男性中，我们发现，在第90天时，功能结局良好（女性为50.9%，男性为57.0%，p = 0.5）、功能结局有利（女性为61.4%，男性为68.8%，p = 0.38）或死亡（女性为8.8%，男性为12.9%，p = 0.60）方面均无显著性别差异。即使在对年龄、基础神经功能缺损严重程度和发病至治疗时间进行调整后，这些结果仍然不变。
接受静脉rtPA治疗的患者在中风后90天时的功能结局不存在性别差异。这一发现可能证实溶栓治疗消除了中风结局中常见的性别差异，并表明中风女性可能从rtPA治疗中获益更多。
