Acciarresi Monica, De Luca Pierpaolo, Caso Valeria, Agnelli Giancarlo, D'Amore Cataldo, Alberti Andrea, Venti Michele, Paciaroni Maurizio
Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
J Stroke Cerebrovasc Dis. 2014 Nov-Dec;23(10):2928-2933. doi: 10.1016/j.jstrokecerebrovasdis.2014.07.044. Epub 2014 Oct 16.
Previous studies have reported that women with stroke often present different stroke symptoms than men. The aim of our study was to assess for the relevance of these differences from a large case series.
Consecutive patients admitted to the Stroke Unit at the University of Perugia, with acute stroke or transient ischemic attack between 1 June, 2005, and May 2012, and recorded in Perugia Stroke Registry were prospectively included. Associations between the recorded symptoms and sex were assessed by preliminary cross-tabulations with the Chi-square test or Fisher exact test with Yate correction when appropriate. Multivariable regression analysis was used to identify independent predictors of a single symptom including sex as an independent variable.
Overall, 1072 men and 811 women were included in this study. Women had a higher average age at onset (75.40 ± 12.90 years in women and 70.14 ± 12.61 years in men) and presented more severe strokes with higher National Institute of Health Stroke Scale scores than men, whereas men were more likely to have a posterior stroke.Regarding symptoms, multivariate analysis revealed correlations between postural instability and male sex and between dysphagia and female sex.
We found no differences in the clinical presentation of stroke between the sexes, except that men were more likely to have postural instability and females were more likely to have dysphagia. These findings suggest that stroke locations and stroke severity were associated with sex.
既往研究报道，中风女性患者的症状常与男性不同。我们研究的目的是通过一个大型病例系列评估这些差异的相关性。
前瞻性纳入2005年6月1日至2012年5月期间入住佩鲁贾大学卒中单元、患有急性中风或短暂性脑缺血发作并记录于佩鲁贾卒中登记处的连续患者。记录的症状与性别之间的关联通过初步交叉表分析，必要时采用卡方检验或经Yate校正的Fisher精确检验进行评估。多变量回归分析用于确定包括性别作为自变量在内的单一症状的独立预测因素。
本研究共纳入1072名男性和811名女性。女性发病时的平均年龄较高（女性为75.40±12.90岁，男性为70.14±12.61岁），且与男性相比，女性的中风更严重，美国国立卫生研究院卒中量表评分更高，而男性更易发生后循环中风。关于症状，多变量分析显示姿势不稳与男性性别、吞咽困难与女性性别之间存在相关性。
我们发现，除男性更易出现姿势不稳、女性更易出现吞咽困难外，两性中风的临床表现并无差异。这些发现表明，中风部位和严重程度与性别有关。
