在DeBakey类型I/II急性大动脉剖析结果中的性别差异:东京急性大动脉超级网络
Toshiyuki Takahashi1,2, Hideaki Yoshino1, Tomoki Shimokawa1
1Tokyo CCU Network Scientific Committee, Tokyo, Japan.
JACC. Advances
|June 28, 2024
概括
男性性别与急性大动脉剖析 (AAD) 患者接受手术,但不接受医疗治疗的住院死亡率较高有关. 需要进一步的研究来了解为什么男性在AAD中手术结果更差.
科学领域:
- 心血管医学 心血管医学
- 胸部外科手术 胸部外科手术
- 医学研究 医学研究
背景情况:
- 在临床表现和DeBakey类型I/II (斯坦福类型A) 急性大动脉解剖 (AAD) 的结果中的性别差异尚未得到充分理解.
- AAD是一种危及生命的疾病,需要及时诊断和管理.
研究的目的:
- 研究性别对I/II型AAD患者的临床表现和住院结果的影响.
- 根据性别,比较手术和医疗治疗的AAD患者之间的结果.
主要方法:
- 从日本多中心注册处 (2013-2018) 分析了3089名I/II型AAD患者.
- 患者分为分层进行手术 (n=2,543) 和医疗 (n=546) 治疗组.
- 用多变量逻辑回归来评估性别和住院死亡率之间的关联.
主要成果:
- 患有AAD的女性年龄较大,并呈现出更多的并发症,包括高脂血症,中风史,意识改变和休克.
- 在手术组中,男性手术前末端器官输血和住院死亡率较高 (OR: 1.71; P < 0.001).
- 在医疗组中,女性心脏吸管和住院死亡率较高,但在调整后没有观察到死亡率的显著性别差异.
结论:
- 男性性别是I/II型AAD手术后在医院死亡率较高的独立预测因素.
- 在接受医疗治疗的患者中,没有发现性别和住院死亡率之间的显著关联.
- 进一步调查导致AAD男性手术结果较差的潜在机制是有必要的.
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