大动脉粥样硬化型脑梗死患者颅内外动脉粥样硬化性狭窄的性别差异

Sex Difference of Intracranial and Extracranial Atherosclerotic Stenosis in Patients with Large Artery Atherosclerotic Cerebral Infarction

摘要: 目的：探讨大动脉粥样硬化(Large artery atherosclerosis, LAA)型脑梗死患者颅内外动脉粥样硬化性狭窄的性别差异。方法：纳入2021年9月到2023年12月期间于青岛大学附属医院神经内科住院的首发LAA型脑梗死患者1036例，收集患者的一般资料和影像学资料，比较男性和女性患者脑动脉狭窄情况的差异。结果：男性颅外动脉粥样硬化性狭窄患病率高于女性(12.5% vs 6.6%, χ² = 17.729, P < 0.001)，女性无症状性脑动脉狭窄患病率高于男性(75.9% vs 67.8%, χ² = 7.183, P = 0.007)，年龄、高脂血症是颅外动脉粥样硬化性狭窄的危险因素。结论：LAA型脑梗死患者脑动脉狭窄部位存在性别差异，女性无症状性脑动脉狭窄患病率更高，男性和女性患者颅外动脉粥样硬化性狭窄的危险因素不同。本研究为不同性别和部位LAA型脑梗死患者制定针对性防治策略提供理论依据。

Abstract: Objective: To investigate the sex difference of intracranial and extracranial atherosclerotic stenosis in patients with Large artery atherosclerosis (LAA) cerebral infarction. Methods: 1036 patients with first onset LAA cerebral infarction admitted to the Department of Neurology, Affiliated Hospital of Qingdao University from September 2021 to December 2023 were included. General and imaging data of the patients were collected to compare the differences in cerebral artery stenosis between male and female patients. Result: The prevalence of extracranial atherosclerotic stenosis in males was higher than that in females (12.5% vs 6.6%, χ² = 17.729, P < 0.001), while the prevalence of asymptomatic cerebral artery stenosis in females was higher than that in males (75.9% vs 67.8%, χ² = 7.183, P = 0.007). Age and hyperlipidemia are risk factors for extracranial atherosclerotic stenosis. Conclusion: There are sex differences in distribution of intracranial and extracranial atherosclerotic stenosis in patients with LAA cerebral infarction. The prevalence of asymptomatic cerebral artery stenosis is higher in women. Risk factors for extracranial atherosclerotic stenosis differ between male and female patients. This study provides theoretical basis for formulating targeted prevention and treatment strategies for patients of LAA cerebral infarction of different sexes and locations.