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对一家三级医疗中心进行的回顾性分析,内容涉及青年成人缺血性卒中血管重建治疗后危险因素、病因及短期临床结局方面的性别差异。

Retrospective analysis of a tertiary care centre of sex differences in risk factors, aetiology and short-term clinical outcome after revascularization treatment in young adults' ischemic stroke.

作者信息

Renna Rosaria, Spagnoletti Gionata, Rippa Mariana, Alfieri Gennaro, Barbato Stefano, Candelaresi Paolo, Capezzuto Carmine, Della Rocca Gennaro, De Mase Antonio, Di Battista Maria Elena, Di Giovanni Mario, Di Iorio Walter, Longo Katia, Loreto Vincenzo, Maurea Carlo, Napolitano Massimo, Petrillo Elisabetta, Ranieri Angelo, Salvatore Simona, Servillo Giovanna, Spina Emanuele, Villani Romolo, Muto Mario, Andreone Vincenzo

机构信息

UOC Neurology - Stroke Unit, AORN Cardarelli, Naples, Italy.

Unit of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

出版信息

Neurol Sci. 2025 Mar;46(3):1237-1244. doi: 10.1007/s10072-024-07859-0. Epub 2024 Nov 18.

Abstract

BACKGROUND AND OBJECTIVES

The incidence of ischemic stroke in young adults has increased substantially. There are limited data in the literature concerning the short-term clinical outcome in young adults with acute stroke after revascularization treatment. Due to the lack of available data on gender differences short-term clinical outcome, we designed the present study.

MATERIALS AND METHODS

We collected data from 127 patients aged 50 years or younger consecutively admitted to the Stroke-Unit of "Cardarelli" Hospital in Naples between August 2017 and September 2022 due to ischemic stroke. All of them underwent thrombolysis and/or endovascular treatment.

RESULTS AND CONCLUSIONS

Smoking, hypertension, and dyslipidemia emerged as the most prevalent risk factors. A gender-based analysis revealed that the history of stroke was the only statistically significant factor more frequently observed in the female group. The leading stroke etiology was "cardioembolism," succeeded by strokes of "other determined origin", "undetermined etiology," "large-artery atherosclerosis," and "small-artery occlusion." Concerning reperfusion therapy, intravenous thrombolysis ranked as the most utilized treatment, followed by "bridging" therapy (combining intravenous thrombolytic therapy with thrombectomy) and primary mechanical thrombectomy. Notably, the average NIHSS scores 7 days post-revascularization were lower among females compared to males, constituting a statistically significant distinction. Nevertheless, no statistically significant correlation surfaced between gender and treatment type in NIHSS mean values at admission, 2 hours, 24 hours post-revascularization, or 7 days post-revascularization. This suggests that the observed disparity in mean NIHSS score between male and female groups after 7 days may potentially stem from other factors, such as endogenous estrogens.

摘要

背景与目的

年轻成年人缺血性卒中的发病率大幅上升。关于接受血管再通治疗的急性卒中年轻成年人的短期临床结局,文献中的数据有限。由于缺乏关于性别差异对短期临床结局影响的可用数据,我们设计了本研究。

材料与方法

我们收集了2017年8月至2022年9月期间因缺血性卒中连续入住那不勒斯“卡雷利”医院卒中单元的127例年龄在50岁及以下患者的数据。他们均接受了溶栓和/或血管内治疗。

结果与结论

吸烟、高血压和血脂异常是最常见的危险因素。基于性别的分析显示,卒中病史是女性组中唯一更频繁观察到的具有统计学意义的因素。主要的卒中病因是“心源性栓塞”,其次是“其他明确病因”、“病因不明”、“大动脉粥样硬化”和“小动脉闭塞”所致的卒中。关于再灌注治疗,静脉溶栓是最常用的治疗方法,其次是“桥接”治疗(静脉溶栓治疗与血栓切除术联合)和直接机械血栓切除术。值得注意的是,血管再通后7天女性的平均美国国立卫生研究院卒中量表(NIHSS)评分低于男性,构成统计学上的显著差异。然而,在入院时、血管再通后2小时、24小时或7天的NIHSS平均值中,性别与治疗类型之间未出现统计学上的显著相关性。这表明,7天后观察到的男性和女性组平均NIHSS评分差异可能潜在地源于其他因素,如内源性雌激素。

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