Pu Yuehua, Wei Na, Yu Dandan, Wang Yilong, Zou Xinying, Soo Yannie O Y, Pan Yuesong, Leung Thomas W H, Wong Lawrence K S, Wang Yongjun, Liu Liping
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, SAR, China.
Neuroepidemiology. 2017;48(1-2):48-54. doi: 10.1159/000469717. Epub 2017 Mar 24.
To date, sex difference in outcomes among patients with intracranial atherosclerosis (ICAS) has rarely been discussed in China as well as in the world. This study aimed to estimate the sex difference in outcomes among patients with ICAS in Chinese cerebral ischemia patients.
We analyzed 1,335 men and women with ICAS who were enrolled in the Chinese Intracranial Atherosclerosis study. They were followed-up for ischemic stroke recurrence, any cause of death, cerebral vascular events (including transient ischemic attack, ischemic and hemorrhagic stroke), combined end points (including cerebral vascular events, angina or myocardial infarction, pulmonary embolism, peripheral vascular events), and unfavorable outcome (modified Rankin scale score of 3-6) at 1 year.
During the follow-up period, 59 (13.44%) combined end points were documented in women and 107 (11.94%) in men. Of the combined end points, 47 were recurrent ischemic stroke events (14 in women and 33 in men), and 51 other causes of deaths (24 in women and 27 in men). There were 349 unfavorable end points (117 in women and 232 in men). The cumulative probability of death was higher in women, but after adjusting for age, diabetes mellitus, hypertension, family history of stroke, current smoker, heavy drinking, hyperhomocysteinemia, and heart disease, there was no significant difference. There was also a lack of difference in 1-year ischemic stroke recurrence, cerebral vascular events, combined end points, and unfavorable outcome between women and men at 1 year.
These results suggest no sex difference in outcome among patients with ICAS in Chinese cerebral ischemia patients.
迄今为止,颅内动脉粥样硬化(ICAS)患者结局的性别差异在国内外鲜有讨论。本研究旨在评估中国脑缺血患者中ICAS患者结局的性别差异。
我们分析了纳入中国颅内动脉粥样硬化研究的1335例患有ICAS的男性和女性。对他们进行了为期1年的随访,观察缺血性卒中复发、任何原因导致的死亡、脑血管事件(包括短暂性脑缺血发作、缺血性和出血性卒中)、复合终点(包括脑血管事件、心绞痛或心肌梗死、肺栓塞、外周血管事件)以及不良结局(改良Rankin量表评分为3 - 6分)。
在随访期间,女性记录到59例(13.44%)复合终点事件,男性记录到107例(11.94%)。在复合终点事件中,47例为复发性缺血性卒中事件(女性14例,男性33例),51例为其他死因(女性24例,男性27例)。有349例不良终点事件(女性117例,男性232例)。女性的累积死亡概率更高,但在调整年龄、糖尿病、高血压、卒中家族史、当前吸烟者、大量饮酒、高同型半胱氨酸血症和心脏病后,无显著差异。1年时,女性和男性在缺血性卒中复发、脑血管事件、复合终点以及不良结局方面也没有差异。
这些结果表明,中国脑缺血患者中ICAS患者的结局不存在性别差异。