动脉瘤性蛛网膜下腔出血患者预后性别差异:倾向性评分匹配分析

Sex difference in prognosis of patients with aneurysmal subarachnoid hemorrhage:matching analysis of propensity score

目的探讨动脉瘤性蛛网膜下腔出血(aSAH)患者预后的性别差异。方法回顾性分析北部战区总医院自2020年4月至2022年1月收治的665例aSAH患者的临床资料。采用1∶1倾向性评分匹配,比较不同性别患者的临床资料,分析预后不良的风险因素。结果倾向性评分匹配后,女性患者迟发性脑缺血、脑积水、改良Rankin量表评分≥2分比例高于男性,差异有统计学意义(P<0.05)。年龄、性别、吸烟、Hunt Hess分级Ⅳ~Ⅴ级、mFisher评分3~4分、迟发性脑缺血、脑积水是aSAH患者出院3个月预后不良的独立危险因素(P<0.05)。结论女性aSAH患者的预后比男性差,这种差异可能与女性患者更易受到迟发性脑缺血和脑积水的影响有关。

Objective To investigate the gender difference in prognosis of patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 665 patients with aSAH admitted to General Hospital of Northern Theater Command from April 2020 to January 2022 were retrospectively analyzed.The clinical data of patients with different genders were compared by 1∶1 propensity score matching,and the risk factors of poor prognosis were analyzed.Results After matching the propensity score,the ratio of delayed cerebral ischemia,hydrocephalus and modified Rankin scale score≥2 points in female patients was higher than that in male patients,and the difference was statistically significant(P<0.05).Age,sex,smoking,Hunt Hess gradeⅣ-Ⅴ,mFisher score 3-4,delayed cerebral ischemia and hydrocephalus were independent risk factors for poor prognosis 3 months after discharge in aSAH patients(P<0.05).Conclusion The prognosis of female aSAH patients is worse than that of male patients,and this difference may be related to female patients′higher susceptibility to delayed cerebral ischemia and hydrocephalus.