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脑内动脉瘤断裂呈现和模型表现的性别特异性差异:来自回顾性队列的证据
Hemanth Krishna Taduka1,2, Prithvinath Reddy Garigapuram3, Srushti Katore3
1CARA Systems Inc, Brooklyn, New York, 11201, USA. hemanthtaduka@carasystems.co.
Annals of biomedical engineering
|December 11, 2025
概括
与男性相比,内动脉瘤 (IA) 破裂的女性更频繁地出现较小的病变和中年. 性别特定的模型对于准确的破裂风险评估至关重要,因为聚合模型可能错误地分类风险.
科学领域:
- 神经学 神经学
- 血管生物学 血管生物学
- 生物统计学 生物统计学
背景情况:
- 内动脉瘤 (IA) 构成严重的健康风险,破裂导致脑下关节下出血.
- 了解IA破裂的性别特异性对于准确的风险分层和临床管理至关重要.
研究的目的:
- 研究内动脉瘤破裂呈现的性别特异性.
- 为了比较性别分层与聚合分类模型在预测IA破裂状态方面的表现.
主要方法:
- 对203名患者 (46名男性,157名女性) 的303例内动脉瘤 (IA) 的回顾性分析.
- 开发性别特异的逻辑回归模型,包括临床和病变特征.
- 通过性别交叉应用对模型性能进行评估.
主要成果:
- 女性患者更经常出现较小的破裂性IA (<5毫米),特别是在前沟通动脉 (ACOM),破裂风险在40-59岁之间达到顶峰.
- 虽然男性的血红蛋白水平较高,但代谢因素在女性 (AUC-ROC:0.80) 中是比男性 (AUC-ROC:0.50) 更重要的预测因素.
- 性别之间的模型交叉应用显著降低了性能,表明了破裂机制的独特生物特征空间.
结论:
- 与男性相比,这个队列中的女性表现出明显的IA破裂模式 (较小的尺寸,中年呈现).
- 性别特定的风险因素和IA破裂的生物机制需要量身定制的预测模型.
- 聚合风险模型可能会错误地分类破裂状态;未来的研究应该专注于包括性别在内的纵向研究,以获得强大的预测工具.
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