急性甲型大动脉解剖中的性别差异:综合性审查和元分析
He Jiao1, Xiankun Liu2, Yiming Bai2
1Medical School, Tianjin University, Tianjin, China; Department of Cardiac Surgery, Chest Hospital, Tianjin University, Tianjin, China.
The American journal of cardiology
|December 26, 2024
概括
患有急性甲型大动脉剖析的女性比男性面临更高的死亡风险和较低的长期存活率,尽管损伤和重新手术的风险较低. 针对女性患者需要量身定制的策略.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 大动脉疾病研究研究
背景情况:
- 急性A型大动脉解剖 (aTAAD) 是一种危及生命的疾病,具有显著的发病率和死亡率.
- 了解aTAAD中的基于性别的差异对于优化患者护理和结果至关重要.
研究的目的:
- 进行对队列研究的元分析,评估急性A型大动脉剖析的临床表现,管理和结果中的性别特异性差异.
- 为了比较被诊断患有TAAD的男性和女性之间的术后和长期生存率.
主要方法:
- 在PubMed,Embase和Cochrane图书馆 (2000-2023) 的系统文献搜索.
- 21项队列研究的元分析,包括6728名女性和12839名男性.
- 使用风险比率 (RR) 和卡普兰-梅尔生存分析评估研究效应.
主要成果:
- 与男性相比,女性的术后急性损伤 (RR 0.85) 和重新手术 (RR 0.89) 的风险较低.
- 妇女经历了更高的术后死亡率 (RR 1.11) 和较差的整体存活率,10年存活率为60.0%,男性为66.5%.
- 在临床表现,管理和结果方面观察到基于性别的显著差异.
结论:
- 急性A型大动脉剖析呈现出明显的基于性别的差异,女性面临更高的术后和长期死亡率.
- 尽管某些并发症的风险较低,但患有TAAD的女性需要有针对性的管理和预防策略.
- 对影响aTAAD的性别特定因素进行进一步的研究是有必要的,以改善患者的治疗结果.
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