伴回流的患者中与性别相关的差异 接受伴回流手术:一个倾向性得分匹配的研究
Edouard Long1,2, Omar Chehab3, Tanisha Rajah4
1Institute of Cardiovascular Science, University College London, London W1W 7TS, UK.
Journal of clinical medicine
|May 14, 2025
概括
接受 mitra valve 手术以进行 mitra regurgitation 的女性出现更多的症状和更高的手术风险,但死亡率与男性相似. 同时的三干预和紧急手术表明结果更差.
科学领域:
- 心血管外科心血管外科
- 心脏门疾病 心脏门疾病
- 医学中的性别差异.
背景情况:
- 关于 mitrale regurgitation (MR) 呈现和手术结果的基于性别的差异尚未得到充分理解.
- 针对MR患者的个性化治疗策略需要澄清性别差异.
- 密特拉 (MV) 手术是严重MR的常见干预.
研究的目的:
- 识别和分析患者特征,手术风险以及对MR的 mitra 门手术后的结果的性别相关差异.
- 为男性和女性MR患者提供量身定制的临床决策和管理协议.
主要方法:
- 对143名连续接受MR手术 (2017-2018) 的患者进行了回顾性分析.
- 按性别分层和倾向分数匹配 (PSM) 来创建可比的男性和女性队列 (38对).
- 评估基线特征,后勤EuroSCORE,手术的紧急性,手术类型和术后结果,包括死亡率和停留时间 (LOS).
主要成果:
- 女性出现了更多的症状 (NYHA 类 ≥ 3),更高的外科手术风险 (EuroSCORE),并接受了更多的紧急手术和中枢置换.
- 经过倾向性得分匹配,女性经历了明显更长的术后停留时间 (LOS),但与男性相比,长期死亡率相似.
- 与绝对LVESD相比,索引左心室末缩直径 (LVESDi) >19 mm/m2显示不良结果的特异性得到改善.
结论:
- 由于MR而接受MV手术的女性表现出明显的临床特征,包括增加的症状和手术风险,以及更长的LOS,但与男性相比的死亡率.
- 同时进行三干预和紧急手术,与男性相比,女性患者的预后明显差.
- 目前的非索引左心室直径值可能无法充分捕捉经过手术的MR患者的性别特异差异.
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