Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
Transl Stroke Res. 2013 Aug;4(4):447-61. doi: 10.1007/s12975-012-0249-7. Epub 2013 Jan 23.
Spinal cord injury (SCI) is a debilitating condition that affects thousands of new individuals each year, the majority of which are males. Males with SCI tend to be injured at an earlier age, mostly during sports or motor vehicle accidents, whereas females tend be injured later in life, particularly in the age group 65 and older. In both experimental and clinical studies, the question as to whether gender affects outcome has been addressed in a variety of patient groups and animal models. Results from experimental paradigms have suggested that a gender bias in outcome exists that favors females and appears to involve the advantageous or disadvantageous effects of the gonadal sex hormones estrogen and progesterone or testosterone, respectively. However, other studies have shown an absence of gender differences in outcome in specific SCI models and work has also questioned the involvement of female sex hormones in the observed outcome improvements in females. Similar controversy exists clinically, in studies that have examined gender disparities in outcome after SCI. The current review examines the experimental and clinical evidence for a gender bias in outcome following SCI and discusses issues that have made it difficult to conclusively answer this question.
脊髓损伤 (SCI) 是一种使人衰弱的疾病，每年都会影响数千名新患者，其中大多数是男性。男性 SCI 患者往往在更年轻时受伤，主要是在运动或机动车事故中，而女性则倾向于在晚年受伤，尤其是在 65 岁及以上的年龄组。在实验和临床研究中，性别是否影响结果的问题已在各种患者群体和动物模型中得到解决。实验范式的结果表明，存在一种性别偏见，有利于女性，这似乎涉及到性腺性激素雌激素和孕激素或睾酮的有利或不利影响。然而，其他研究表明，在特定的 SCI 模型中，结果没有性别差异，而且研究也质疑女性性激素是否参与了观察到的女性结果改善。在检查 SCI 后结果性别差异的临床研究中，也存在类似的争议。目前的综述检查了 SCI 后结果存在性别偏见的实验和临床证据，并讨论了一些使人们难以得出明确答案的问题。
