Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland.
Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland; Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland.
Neurol Neurochir Pol. 2018 Mar;52(2):162-167. doi: 10.1016/j.pjnns.2017.09.002. Epub 2017 Sep 20.
There is little data about sex differences in carotid atherosclerosis in the early phase after an ischemic event. The aim of this study was to examine the carotid artery atherosclerosis differences between men and women in early phase after TIA or stroke.
Consecutive patients with recent ischemic event, admitted during the first week after symptom onset were examined with ultrasound. Sex differences in degree of stenosis, number of plaques and plaque morphology were compared. Plaque morphology was assessed by gray-scale median (GSM), according to which lower values were associated with hemorrhagic/necrotic core indicating plaque instability.
Of the 316 patients with ischemic events, 196 (50.5% male) entered the study. Men had more often moderate as well as severe ipsilateral carotid stenosis (12.1% vs 7.2% for moderate and 12.1% vs 2.1% for severe; p=0.024). Men had more often the largest plaque hypoechogenic contralateral (62.6% vs 37.1%, p=0.0008), but not ipsilateral. Men had 3 or more hypoechogenic plaques (24.2% vs 4.1%, p=0.0001; 17.2% vs 4.1%, p<0.0001) both ipsi and contralateral respectively. Male sex was a risk factor for having 3 or more ipsilateral hypoechogenic plaques (p=0.002, OR=20 CI 95% [5.5-75].
Men had more often carotid stenosis and higher number of hypoechogenic plaques.
缺血性事件后早期颈动脉粥样硬化的性别差异数据较少。本研究旨在检查短暂性脑缺血发作或中风后早期男性和女性颈动脉粥样硬化的差异。
连续入组近期发生缺血性事件且在症状发作后第一周内入院的患者，进行超声检查。比较狭窄程度、斑块数量和斑块形态的性别差异。根据灰阶中位数（GSM）评估斑块形态，低值与提示斑块不稳定的出血/坏死核心相关。
316 例缺血性事件患者中，196 例（50.5%为男性）入组本研究。男性更常发生同侧颈动脉中度及重度狭窄（中度狭窄为 12.1% vs 7.2%；重度狭窄为 12.1% vs 2.1%；p=0.024）。男性更常发生对侧最大斑块低回声（62.6% vs 37.1%，p=0.0008），而同侧则不然。男性同侧及对侧分别有 3 个或更多低回声斑块（24.2% vs 4.1%，p=0.0001；17.2% vs 4.1%，p<0.0001）。男性为同侧 3 个或更多低回声斑块的危险因素（p=0.002，OR 95%CI [5.5-75]为 20）。
男性更常发生颈动脉狭窄和更多数量的低回声斑块。
