新疆地区急性脑卒中患者临床特征的性别差异研究

Gender differences of clinical characteristics in acute stroke in Xinjing

目的探讨新疆地区不同性别急性脑卒中患者临床特点的差异性。方法前瞻性连续登记新疆生产建设兵团医院自2008年6月～2011年7月收治的急性脑卒中患者971例,其中男性598例,女性383例,收集相关临床资料,并对所有患者进行长期随访,比较男女脑卒中患者一般资料、卒中类型、牛津郡社区脑卒中分型(OC-SP分型)、相关并发症、及预后方面的不同。结果新疆地区急性脑卒中患者临床类型存在性别差异(P=0.017),急性脑梗死及脑出血男性比例高于女性,短暂性脑缺血发作(TIA)患者女性比例高于男性;男性患者在高血压构成比(P<0.001)、房颤(P=0.011)、吸烟(P<0.001)、酗酒(P<0.001)、凝血酶原时间(PT)(P=0.039)、血红蛋白含量(HGB)(P<0.001)、肌酐值(P=0.001)高于女性患者,而女性患者在心脏瓣膜病(P=0.002)、糖尿病(P=0.013)、高密度脂蛋白(HDL)(P<0.001)、低密度脂蛋白(LDL)(P<0.001)、总胆固醇(CHE)(P<0.001)高于男性;OCSP分型男女性患者无显著差异;急性脑卒中相关并发症方面,女性患者泌尿系感染(P<0.001)、电解质紊乱(P=0.005)高于男性;基线严重程度评分Glasgow昏迷量表(GCS评分)、斯堪的那亚卒中量表(SSS评分)、美国国立卫生院脑卒中量表(NIHSS评分)与一个月及2年的Barthel指数(BI)和改良的Rankin量表(MRS评分)无明显差异。结论新疆地区不同性别间急性脑卒中临床类型、相关危险因素及卒中相关并发症存在差异,基线严重程度评分及临床预后无明显差异。

Objective To study on gender differences of clinical characteristics in acute stroke in Xinjing. Methods Of 971 acute stroke patients from Bingtuan Hospital of Xinjiang,598 were men and 383 were women. Baseline character- istics, OCSP, correlated complications, and outcomes data of women were compared to those of men. Results There were differences in subtypes of acute stroke between women and men in Xinjing （P = 0. 017）. On the rate of cerebral infarction and cerebral hemorrhage, men was higher than women, but on the rate of TIA, men was less than women. Men were higher than women in hypertension and constituent ratio （ P 〈 0.001 ）, atrial fibrillation （ P = 0. 011 ）, smoking （ P = 0.03 ）, intem- perance （ P 〈 0. 001 ）, PT （ P = 0.039 ）, HGB （ P 〈 0.001 ）, useanitrogen （ P = 0.001 ）, valvular heart disease （ P = 0. 002 ）, the history of diabetes（P =0. 013）, （HDL） （P 〈0. 001 ）, （LDL） （P 〈0. 001 ） and CHE （P 〈0.001 ）. There were not sta- tistical difference between male and female in OCSP,with the complications,urinary infection（P 〈 0. 001 ） ,and electrolyte disorder（ P = 0. 005 ）. Baseline SSS, GCS, NIHSS, 1 month-2 years outcome in BI and MRS were not different between women and men with acute stroke. Conclusions There are some gender differences in common risk factors, subtypes and complications outcomes with acute stroke in Xinjing. Baseline characteristics, as well as clinical outcomes were not different between women and men.