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不同年龄段儿科人群脑震荡及伤后认知结果的性别差异

Gender Differences in Concussion and Postinjury Cognitive Findings in an Older and Younger Pediatric Population.

作者信息

Tanveer Sarah, Zecavati Nassim, Delasobera Elizabeth Bronson, Oyegbile Temitayo Oyefunmike

出版信息

Pediatr Neurol. 2017 May;70:44-49. doi: 10.1016/j.pediatrneurol.2017.02.001. Epub 2017 Feb 9.

DOI:10.1016/j.pediatrneurol.2017.02.001
PMID:28320567
Abstract

BACKGROUND

Studies have documented gender differences associated with concussion. The purpose of this study was to determine if these gender differences are also noted within a pediatric population.

METHODS

This prospective study analyzed 1971 patients who had completed preconcussion and postconcussion neuropsychological testing within the Washington, DC, area.

RESULTS

Our results showed that children and adolescents with concussion exhibit gender differences with respect to risk factors, recovery, and symptomatology. Females are more likely to present with a concussion (P < 0.001), experience more discomfort from a concussion (P < 0.001), and seek treatment for postconcussive headaches (P < 0.001). On the other hand, males are more likely to sustain a concussion from a contact sport (P < 0.001) and experience loss of consciousness, confusion, and amnesia with a concussion more frequently than females (P < 0.001). Postconcussive cognitive function also differs by gender. Both males and females exhibit a decline in cognitive testing compared with baseline (P < 0.001); however, visual memory (P = 0.02) is more affected in females than in males. These findings remain unchanged among pediatric patients aged ≥14 years; however, no gender differences were noted in individuals aged ≤13 years.

CONCLUSION

It is important for health care providers, schools, athletic trainers, and coaches to be aware of these gender differences associated with concussion in order to provide adequate surveillance and appropriate monitoring and support during the recovery period.

摘要

背景

研究已记录了与脑震荡相关的性别差异。本研究的目的是确定在儿科人群中是否也存在这些性别差异。

方法

这项前瞻性研究分析了华盛顿特区地区1971名完成脑震荡前和脑震荡后神经心理学测试的患者。

结果

我们的结果表明,患有脑震荡的儿童和青少年在危险因素、恢复情况和症状方面存在性别差异。女性更易发生脑震荡(P < 0.001),因脑震荡感到更不适(P < 0.001),且更常因脑震荡后头痛寻求治疗(P < 0.001)。另一方面,男性因接触性运动导致脑震荡的可能性更大(P < 0.001),且脑震荡时比女性更常出现意识丧失、意识模糊和失忆(P < 0.001)。脑震荡后的认知功能也存在性别差异。与基线相比,男性和女性的认知测试均有所下降(P < 0.001);然而,视觉记忆(P = 0.02)在女性中比在男性中受影响更大。在≥14岁的儿科患者中,这些发现保持不变;然而,在≤13岁的个体中未发现性别差异。

结论

医疗保健提供者、学校、运动训练师和教练了解这些与脑震荡相关的性别差异很重要,以便在恢复期间提供充分的监测以及适当的监督和支持。

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