腔隙性卒中患者静脉溶栓功能结局的性别差异
Sex differences in functional outcomes of intravenous thrombolysis among patients with lacunar stroke.
作者信息
Wueger Patrizia, Noseda Roberta, Pagnamenta Alberto, Bianco Giovanni, Seiffge David, Michel Patrik, Nedeltchev Krassen, Bonati Leo, Kägi Georg, Niederhauser Julien, Nyffeler Thomas, Luft Andreas, Wegener Susanne, Schelosky Ludwig, Medlin Friedrich, Rodic Biljana, Peters Nils, Renaud Susanne, Mono Marie Luise, Carrera Emmanuel, Fischer Urs, De Marchis Gian Marco, Cereda Carlo W
机构信息
Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland.
Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland.
出版信息
Front Neurol. 2024 Feb 13;15:1341423. doi: 10.3389/fneur.2024.1341423. eCollection 2024.
BACKGROUND
This study aimed to assess if there are sex differences in the functional outcome of intravenous thrombolysis (IVT) among patients with lacunar stroke (LS).
METHODS
Consecutive patients admitted from 1 January 2014 to 31 January 2020 to hospitals participating in the Swiss Stroke Registry presenting with LS and treated with IVT were included. The study population was then divided into two groups based on patient sex, and a multivariable ordinal logistic regression analysis was performed to uncover sex differences in the modified Rankin Scale (mRS) score at 90 days after stroke.
RESULTS
A total of 413 patients with LS were treated with IVT: 177 (42.9%) women and 236 (57.1%) men. Women were older than men (median age 74 years, 25th-75th percentiles 67-84 years versus 70 years, 25th-75th percentiles 60-80 years, value of p 0.001) and, after adjustment for meaningful variables, showed more frequently increased odds of a higher mRS score at 90 days after stroke (adjusted odds ratio 1.49, 95% confidence interval 1.01-2.19, value of p 0.044).
CONCLUSION
This study showed that female sex increased the odds of a worse functional response to IVT in patients with LS. Future studies should further elucidate the mechanisms underlying such sex differences.
背景
本研究旨在评估腔隙性卒中（LS）患者静脉溶栓（IVT）功能结局是否存在性别差异。
方法
纳入2014年1月1日至2020年1月31日连续入住参与瑞士卒中登记的医院、表现为LS并接受IVT治疗的患者。然后根据患者性别将研究人群分为两组，并进行多变量有序逻辑回归分析，以揭示卒中后90天时改良Rankin量表（mRS）评分的性别差异。
结果
共有413例LS患者接受了IVT治疗：177例（42.9%）为女性，236例（57.1%）为男性。女性比男性年龄更大（中位年龄74岁，第25-75百分位数为67-84岁，而男性为70岁，第25-75百分位数为60-80岁，p值为0.001），并且在对有意义的变量进行调整后，卒中后90天时mRS评分较高的几率更频繁增加（调整后的优势比为1.49，95%置信区间为1.01-2.19，p值为0.044）。
结论
本研究表明，女性增加了LS患者对IVT功能反应较差的几率。未来的研究应进一步阐明这种性别差异的潜在机制。
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