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【Stroke】儿童期缺血性卒中男童更为多见
Male Predominance in Childhood Ischemic Stroke. Findings From the International Pediatric Stroke Study
Meredith R. Golomb MD, MSc*; Heather J. Fullerton MD, MAS; Ulrike Nowak-Gottl MD; Gabrielle deVeber MD, MHSc; for the International Pediatric Stroke Study Group
From the Department of Neurology (M.R.G.), Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, IN; the Departments of Neurology and Pediatrics (H.J.F.), University of California, San Francisco, Calif; Department of Pediatric Hematology/Oncology (U.N.-G.), University Children's Hospital, University of Münster, Münster, Germany; and the Department of Neurology (G.d.V.), Hospital for Sick Children, Toronto, Ontario, Canada.
* To whom correspondence should be addressed. E-mail: mgolomb@iupui.edu.
Background and Purpose—Previous studies suggested a male predominance in childhood ischemic stroke, mirroring gender differences in adults but were limited by small sample sizes or unconfirmed diagnoses. We sought to study gender within a large international series of confirmed cases of pediatric ischemic stroke.
Methods—From January 2003 to July 2007, the International Pediatric Stroke Study enrolled children (0 up to 19 years) with arterial ischemic stroke or cerebral sinovenous thrombosis at 30 centers in 10 countries. Neonates were those <29 days of age. We calculated the "expected" gender ratio for our study as the weighted average of population-based childhood gender ratios in enrolling countries weighted by the number of subjects enrolled in each country. 2 tests were used to compare the observed gender ratios in our series with this expected ratio (51.7%).
Results—Among 1187 children with confirmed ischemic stroke, 710 were boys (60%, P<0.0001). Male predominance persisted after stratification by age (61% for neonates, P=0.011; 59% for later childhood, P=0.002) and stroke subtype (58% for arterial ischemic stroke, P=0.004; 65% for cerebral sinovenous thrombosis, P=0.002). The greatest proportion of males occurred among children with arterial ischemic stroke and a history of trauma (75%, P=0.008), although boys were also overrepresented among those with arterial ischemic stroke and no trauma (57%; P=0.07). There were no gender differences in case fatality or deficits at discharge.
Conclusions—Childhood ischemic stroke appears to be more common in boys regardless of age, stroke subtype, or history of trauma. Further exploration of this gender difference could shed light on stroke mechanisms in both children and adults. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 抱歉，这2天比较忙，翻晚了
背景和目的：以前的研究发现，儿童期缺血性中风中男童的比例较高，这和成人中发现的性别差异类似，但由于样本量小和诊断不明确无法得到定论。我们试图通过国际间合作研究儿童期缺血性中风的性别差异。
方法：自2003年至2007年7月，国际儿童中风研究小组在10个国家的30个中心收集了0－19岁患有缺血性中风或大脑窦静脉血栓儿童病例。新生儿指出生后<29天的婴儿。我们依据招募国人口中儿童的性别比的平均值与每个国家的样本数加权后得到加权平均值作为预期的性别比。用两种试验来比较观察的性别比和预期的性别比。
结果：在1187名确诊为缺血性脑中风的患儿中，710人为男性（60％，P<0.0001）。在按年龄（新生儿61％，P＝0.011；其他59％，P＝0.002）和中风亚型（动脉缺血性中风58％，P=0.004；大脑窦静脉血栓65％，P＝0.002）分层后，男性仍占优势。男童比例最高的在动脉缺血性中风和外伤史的患儿(75%, P=0.008), 尽管有动脉缺血性中风，但没有外伤史的患儿中男童也很多（57%, P=0.07）。在病死率和出院后缺陷方面没有性别差异。
结论：儿童缺血性中风男孩更为常见，与年龄、中风亚型、外伤史无关。性别差异的深入研究有助于揭开儿童和成人中风的机制。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-04-17 17:11
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