Department of Neurology, Wake Forest School of Medicine, Winston Salem, NC, USA.
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Lancet Neurol. 2018 Jul;17(7):641-650. doi: 10.1016/S1474-4422(18)30201-1.
With the greater availability of treatments for acute ischaemic stroke, including advances in endovascular therapy, personalised assessment of patients before treatment is more important than ever. Women have a higher lifetime risk of stroke; therefore, reducing potential sex differences in the acute stroke setting is crucial for the provision of equitable and fast treatment. Evidence indicates sex differences in prevalence and types of non-traditional stroke symptoms or signs, prevalence of stroke mimics, and door-to-imaging times, but no substantial differences in use of emergency medical services, stroke knowledge, eligibility for or access to thrombolysis or thrombectomy, or outcomes after either therapy. Women presenting with stroke mimics or non-traditional stroke symptoms can be misdiagnosed, which can lead to inappropriate triage, and acute treatment delays. It is essential for health-care providers to recognise possible sex differences in stroke symptoms, signs, and mimics. Future studies focused on confounders that affect treatment and outcomes, such as age and pre-stroke function, are also needed.
随着急性缺血性脑卒中治疗方法（包括血管内治疗技术的进步）的日益普及，在治疗前对患者进行个性化评估比以往任何时候都更加重要。女性一生中发生中风的风险更高；因此，减少急性中风环境中潜在的性别差异对于提供公平和快速的治疗至关重要。有证据表明，在非传统的中风症状或体征、中风模拟的发生率、门到影像时间方面存在性别差异，但在使用紧急医疗服务、中风知识、溶栓或取栓的资格或途径，或两种治疗方法后的结果方面没有实质性差异。出现中风模拟或非传统中风症状的女性可能会被误诊，这可能导致分诊不当和急性治疗延误。医疗保健提供者必须认识到中风症状、体征和模拟方面可能存在的性别差异。还需要未来的研究来关注影响治疗和结果的混杂因素，如年龄和中风前的功能。
