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Гендерные особенности течения и прогноза ишемического инсульта
Гендерные особенности течения и прогноза ишемического инсульта
Максимова М.Ю., Айрапетова А.С. Гендерные особенности течения и прогноза ишемического инсульта. Consilium Medicum. 2019; 21 (9): 9–15. DOI: 10.26442/20751753.2019.9.190463
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Аннотация
Влияние гендерных различий на течение инсульта и восстановление нарушенных неврологических функций до настоящего времени изучено недо-статочно. Наиболее часто гендерные различия прогноза после инсульта объясняются тем, что в момент инсульта женщины обычно старше муж-чин, имеют больше факторов риска и широкий спектр сопутствующих заболеваний, сниженный функциональный и когнитивный статус, чаще яв-ляются социально изолированными. Кардиогенный эмболический инсульт чаще встречается у женщин, атеротромботический инсульт чаще воз-никает у мужчин. Для женщин характерно развитие инсульта в каротидной системе, у мужчин инсульт чаще развивается в вертебробазилярной системе. Женщины подвержены более тяжелому течению инсульта. Позднее обращение женщин за медицинской помощью и сопутствующая значительно выраженная соматическая патология препятствуют проведению тромболизиса и вторичной профилактике инсульта в полном объе-ме. Прогноз, отдаленное течение и функциональное восстановление после инсульта у женщин являются неблагоприятными. У женщин чаще раз-вивается постинсультная депрессия и в большей степени снижается качество жизни по сравнению с мужчинами.
Ключевые слова: ишемический инсульт, гендерные особенности.
Ключевые слова: ишемический инсульт, гендерные особенности.
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Today the impact of gender differences on stroke severity and fuctional recovery after stroke is still not well understood. Most often the gender differences in stroke outcomes are explained by the fact that women are usually older than men at the time of stroke onset, they have more risk factors and a higher comorbidity, a worse functional and cognitive status, and they are more often socially isolated than men. Cardioembolic stroke is more often diagnosed in women, atherothrombotic stroke occurs more frequent in men. Women have a higher prevalence of stroke in the carotid artery system, stroke in the vertebrobasilar system is more common in men. Compared with men, women have more severe stroke. Women’s delays in arrival to hospital, the presence of severe comorbidity lead to lower use of thrombolysis and limit appropriate secondary prevention of stroke. The prognosis, long-term outcome and functional recovery after stroke are unfavorable in women. Women more likely to develop post-stroke depression and they have a poorer quality of life after stroke than men.
Key words: ischemic stroke, gender differences.
Key words: ischemic stroke, gender differences.
Полный текст
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Авторы
М.Ю. Максимова*, А.С. Айрапетова
ФГБНУ «Научный центр неврологии», Москва, Россия
*ncnmaximova@mail.ru
Research Center of Neurology, Moscow, Russia
*ncnmaximova@mail.ru
ФГБНУ «Научный центр неврологии», Москва, Россия
*ncnmaximova@mail.ru
________________________________________________
Research Center of Neurology, Moscow, Russia
*ncnmaximova@mail.ru
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