Weber Ralph, Winezki Evgenia, Katsanos Aristeidis H, Cueillette Melissa, Hajjar Karim, Yamac Elif, Veltkamp Roland, Chapot Rene
Department of Neurology, Alfried Krupp Hospital Essen, Alfried-Krupp-Str. 21, 45131, Essen, Germany.
Division of Neurology, McMaster University & Population Health Research Institute, Hamilton, Canada.
Neurol Res Pract. 2022 Oct 17;4(1):50. doi: 10.1186/s42466-022-00215-7.
Although there are well known sex differences in older patients with ischemic stroke receiving acute reperfusion treatments, there is paucity of data in younger patients.
We investigated sex-related differences in clinical presentation, stroke etiology and short-term outcomes in consecutive young patients with acute ischemic stroke (AIS) below the age of 50 years receiving mechanical thrombectomy (MT) between January 2011 and May 2021 in a tertiary stroke center.
We identified a total of 202 young ischemic stroke patients with MT, with 51% being female. Young female AIS patients were significantly younger (39 ± 8 vs. 43 ± 7 years, p < 0.001), and presented with a trend for more severe stroke on admission (median NIHSS 12 vs. 9, p = 0.065), compared to males, respectively. Young female AIS patients had higher rates of embolic strokes of determined or undetermined sources in the anterior circulation, while young male AIS patients suffered more often strokes of arterio-arterial embolism. Complete reperfusion (TICI score 3) was achieved significantly less often in young female AIS patients (69% vs. 83%, p = 0.006), and in-hospital mortality was 2-times higher (5% vs. 2%, p = 0.271) compared to males.
Young female AIS patients receiving MT have higher rates of severe embolic strokes and less often complete reperfusion due to different occlusion sites and stroke etiology compared to males.
尽管在接受急性再灌注治疗的老年缺血性中风患者中存在众所周知的性别差异，但年轻患者的数据却很少。
我们调查了2011年1月至2021年5月期间在一家三级中风中心接受机械取栓术（MT）的连续50岁以下急性缺血性中风（AIS）年轻患者在临床表现、中风病因和短期预后方面的性别差异。
我们共确定了202例接受MT的年轻缺血性中风患者，其中51%为女性。年轻女性AIS患者明显更年轻（39±8岁对43±7岁，p<0.001），与男性相比，入院时中风严重程度有增加趋势（NIHSS中位数12对9，p=0.065）。年轻女性AIS患者在前循环中由确定或不确定来源引起的栓塞性中风发生率较高，而年轻男性AIS患者动脉-动脉栓塞性中风更为常见。年轻女性AIS患者实现完全再灌注（TICI评分3）的比例明显较低（69%对83%，p=0.006），且住院死亡率是男性的2倍（5%对2%，p=0.271）。
与男性相比，接受MT的年轻女性AIS患者由于不同的闭塞部位和中风病因，严重栓塞性中风发生率较高，完全再灌注的比例较低。
