性别对非裔美国人复发性卒中结局的影响：来自非裔美国人抗血小板卒中预防研究的结果。
Effect of sex on outcome after recurrent stroke in African Americans: results from the African American Antiplatelet Stroke Prevention Study.
机构信息
Department of Neurology and Rehabilitation, Section of Cerebrovascular Disease and Neurological Critical Care, University of Illinois College of Medicine at Chicago, Chicago, IL 60612, USA.
出版信息
J Stroke Cerebrovasc Dis. 2010 Jul-Aug;19(4):321-5. doi: 10.1016/j.jstrokecerebrovasdis.2009.05.008. Epub 2010 May 4.
BACKGROUND
Sex-related disparities in stroke have been previously reported. However, the influence of sex on the outcome of recurrent stroke in African Americans is less clear. Our objective was to investigate the effect of sex on the outcome of recurrent nonfatal stroke in the African American Antiplatelet Stroke Prevention Study (AAASPS).
METHODS
The AAASPS is a double-blind, randomized, controlled trial of recurrent stroke prevention in African Americans. Participants (967 women and 842 men) with noncardioembolic ischemic stroke were assigned to receive ticlopidine or aspirin and were followed up for up to 2 years. The National Institutes of Health Stroke Scale (NIHSS) score, modified Barthel score (mBS), and Glasgow Outcome Scale (GOS) score were determined at enrollment, at prespecified times thereafter, and at the time of recurrent stroke. Survival analysis was used to test for a significant difference in the time to recurrent stroke between women and men.
RESULTS
Of the total 1809 subjects enrolled in AAASPS, 186 (89 women and 97 men) experienced recurrent nonfatal stroke. At enrollment, the NIHSS score (2.87 for women and 3.00 for men; P=.73), the mBS (18.26 for women and 18.52 for men; P=.47) and the GOS score (1.49 for women and 1.51 for men; P=.86) were not significantly different. In follow-up and at the time of stroke recurrence, the NIHSS score, mBS, and GOS score were similar for both groups, except for the mBS at the 6-month visit, which was lower in women (18.49) than in men (19.37) (P=.02). In the survival analysis, no significant difference in the time to recurrent stroke was found between women and men (P=.69).
CONCLUSIONS
Although sex-related stroke disparities have been reported, in the AAASPS cohort outcomes for recurrent nonfatal noncardioembolic ischemic stroke for women were not significantly different than for men. Differences in study populations and methodologies may explain discrepancies in results from the various studies.
背景
先前已有研究报道了与性别相关的中风差异。然而，性别的影响在非裔美国人复发性中风的结果中尚不清楚。我们的目的是调查性别对非裔美国人抗血小板卒中预防研究（AAASPS）中复发性非致命性中风结果的影响。
方法
AAASPS 是一项针对非心源性缺血性中风复发预防的双盲、随机、对照试验。将 967 名女性和 842 名男性参与者分配接受噻氯匹定或阿司匹林治疗，并随访长达 2 年。在入组时、此后的预定时间以及复发性中风时，确定国立卫生研究院中风量表（NIHSS）评分、改良巴氏量表（mBS）和格拉斯哥结局量表（GOS）评分。生存分析用于检验女性和男性之间复发性中风时间的显著差异。
结果
在 AAASPS 中总共纳入了 1809 名受试者，186 名（89 名女性和 97 名男性）经历了复发性非致命性中风。在入组时，NIHSS 评分（女性为 2.87，男性为 3.00；P=.73）、mBS（女性为 18.26，男性为 18.52；P=.47）和 GOS 评分（女性为 1.49，男性为 1.51；P=.86）没有显著差异。在随访和中风复发时，两组的 NIHSS 评分、mBS 和 GOS 评分相似，除了女性（18.49）在 6 个月时的 mBS 评分低于男性（19.37）（P=.02）。在生存分析中，女性和男性之间复发性中风的时间没有显著差异（P=.69）。
结论
尽管先前有研究报道了与性别相关的中风差异，但在 AAASPS 队列中，女性非心源性缺血性非致命性中风的复发性结果与男性没有显著差异。研究人群和方法的差异可能解释了来自不同研究的结果存在差异。
Zotero 插件