伴有代谢综合征的首发缺血性卒中患者性别差异的横断面研究

目的旨在初步研究伴有代谢综合征(metabolic syndrome,MS)的首发缺血性卒中(first-ever ischemicstroke,FIS)患者在入院时基线水平的性别差异。方法对2008年8月～2009年11月在北京天坛医院神经内科住院的连续入组的FIS患者进行横断面调查。依据国际糖尿病联盟(the International Diabetes Federation,IDF)2005年对MS的定义对入选患者进行分组,对比男性、女性患者之间的差异。结果 602例FIS患者中,男411例(占68.5%)、女191例(占31.7%),伴MS患者共234例,其中男11 7例,占男性FIS患者的28.5%;女117例,占女性FIS患者的61.5%。男性伴MS患者吸烟、饮酒发生率明显高于伴Ms的女性(74.5% vs 14.5%,P0.001;66.7% vs 4.5%,P0.001)。中心性肥胖、低高密度脂蛋白、高血压发生率在女性明显高于男性(79.1% vs 34.8%,P0.001;62.8% vs 38.9%,P0.001;97.4%vs 89.1%,P=0.024)。女性伴MS的患者同女性不伴MS的患者比较,患大动脉粥样硬化性(largeartery atherosclerosis,LAA)缺血性卒中的风险更高(67.4%vs 48.4%,P=0.011)。男性伴MS的患者同男性不伴MS的患者比较,在此卒中亚型上未见显著差异(29.2%vs 25.3%,P=0.490)。结论在FIS患者中,女性患者MS的发生率远高于男性患者。在伴有MS的FIS患者当中,和女性相比,男性更常见的危险因素为吸烟、饮酒;而和男性相比,女性更常见的危险因素为中心性肥胖及低高密度脂蛋白、高血压。伴MS的女性FIS患者,更易感LAA性缺血性卒中,而在伴MS的男性患者中未见到明显卒中亚型的差别。

A Cross Sectional Research on Gender Difference for The First-Ever Ischemic Stroke Patients with Metabolic Syndrome

Objective To investigate the gender differences for the first-ever ischemic stroke （FIS） patients with metabolic syndrome （MS） on basic levels. Methods Inpatients with FIS were enrolled consistently into our study from Aug. 2008 to Nov. 2009. A cross-sectional study was conducted in these patients. According to the definition of metabolic syndrome by the International Diabetes Federation （IDF）, the patients were divided into different groups in order to comprehend the difference in gender. Results Six hundreds and two patients with FIS were enrolled in our study, the male was 411 （68.3%o）, the female was 191 （31.7%）. 234 inpatients were found with MS among in these patients, the male and female was all 117. The incidence of MS in the male and female was 28.5% and 61.3% respectively. Compared to the female, the incidence of smoking and drinking were higher in the male （74.3% vs 14.5%, P〈0.001 66.7% vs 4.3%, P〈O.001）. While compared to the male, the incidence of abdominal obesity and low high density lipoprotein （HDL）, hypertension were higher in the female （79.1% vs 34.8%, P〈0.001; 62.8% vs 38.9%, P〈0.001; 97.4% vs 89.1%, P=0.024）. The incidence of large artery atherosclerosis （LAA） stroke and non-LAA stroke was 67.4% vs 48.4% （P=0.011） in the female with MS, when compared to the female without MS. While in the male, it was 29.2% vs 25.3% （P=0.490）, when the two group were compared. Conclusion The incidence of MS in FIS patients was much higher in the female than that in the male. Smoking and drinking were common risk factors in the man with MS than those in the woman, but abdominal obesity and low HDL, hypertension were common risk factors in the women. The female with MS had the trend to be LAA stroke more easily than the female without MS, but this feature was not found in the male.