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- 저자 : Mingsu Liu (검색결과 1 건)
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The Influence of Sex in Stroke Thrombolysis: A Systematic Review and Meta-Analysis
Mingsu Liu,Guangqin Li,Jie Tang,Yan Liao,Lin Li,YANGZHENG,Tongli Guo,Xin Kang,Maoting Yuan 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.2
Background and Purpose There is increasing recognition of the importance of stroke infemales to both clinical and public health. The natural course of stroke is worse in femalesthan in males, but the evidence regarding sex disparities in the responses to thrombolysis instroke patents is still controversial. We compared outcomes after thrombolysis treatment betweenfemales and males. Methods Clinical trials reported in the Embase, PubMed, and Cochrane Library electronicdatabases up to March 13, 2017 were included in this analysis. Two reviewers independentlyextracted the data and conducted quality assessments. Statistical tests were performed to checkfor heterogeneity and publication bias. Sensitivity analysis was also performed to evaluate thestability of the conclusions. Results Sixteen reports involving 60,159 patients were available for analysis. The female patientswere a 0.89-fold [95% confidence interval (CI)=0.87–0.90, p<0.001], 0.89-fold (95%CI=0.87–0.91, p<0.001), and 1.24-fold (95% CI=1.11–1.36, p<0.001) more likely to obtain good,excellent, and poor functional outcomes, respectively, with no significant difference in thecomplications of symptomatic intracranial hemorrhage among the sexes [risk ratios (RR)=0.99,95% CI=0.92–1.07, p=0.81] after thrombolysis treatment. In addition, the prevalence of a goodfunctional outcome did not differ significantly between females and males in the intra-arterialthrombolysis (IAT) group (RR=1.05, 95% CI=0.85–1.29, p=0.67) in a subgroup analysis. Conclusions This study has demonstrated that females often exhibit a worse outcome thanmales after intravenous thrombolysis (IVT), whereas no relevant sex differences were found inoutcome or recanalization after IAT, with safety regarding hemorrhage complications fromthrombolysis being the same for the sexes. However, IVT should not be withheld from femalestroke patients solely based on their sex before the findings are confirmed in further large-scaleresearch.
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