Stroke:急性缺血性卒中后正常白质的结构完整性和性别特异性结局!

2017-11-11 xing.T MedSci原创

由此可见,女性与急性缺血性卒中后较大的预后不良可能性有关。白质的完整性和女性功能预后指标之间的相关性,而不是男性,意味着存在一个潜在的性别特异性机制。

女性的卒中预后比男性要差。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在评估急性缺血性脑卒中后与功能恢复相关的白质临床和影像学特点的性别差异。

研究人员对入院时进行脑MRI检查和3-6个月评估改良Rankin量表评分的急性缺血性脑卒中患者进行了回顾性分析。研究人员采用液体衰减反转恢复和扩散张量成像来分别量化患者的脑白质高信号与急性脑梗死体积,并对急性缺血对侧正常白质的扩散各向异性系数进行了计算。

该研究共纳入了319例急性缺血性卒中患者,女性患者年龄较大(68岁 vs. 62.7岁,P=0.004),心房颤动发生率有所增加(21.4% vs. 12.2%,P=0.04),吸烟率较低(21.1% vs. 35.9%,P=0.03)。在白质高信号体积、急性脑梗死体积、美国国立卫生院卒中量表、卒中前改良Rankin量表评分或正常的白质的扩散各向异性指标上并无性别差异。然而,女性不太可能有一个很好的结局(改良Rankin Scale评分<2:49.6% vs. 67%;P = 0.005)。在logistic回归分析中,女性以及性别与分数各向异性、径向扩散系数和轴向扩散率之间的交互作用是功能预后的独立预测因子。

由此可见,女性与急性缺血性卒中后较大的预后不良可能性有关。白质的完整性和女性功能预后指标之间的相关性,而不是男性,意味着存在一个潜在的性别特异性机制。

原始出处:

Mark R. Etherton,et al. Structural Integrity of Normal Appearing White Matter and Sex-Specific Outcomes After Acute Ischemic Stroke.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.117.019258

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    2017-11-11 Y—xianghai

    学习了新知识

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