Prati P, Vanuzzo D, Casaroli M, Di Chiara A, De Biasi F, Feruglio G A, Touboul P J
Neurology Department, San Daniele Hospital, San Daniele UD, Italy.
Stroke. 1992 Dec;23(12):1705-11. doi: 10.1161/01.str.23.12.1705.
The aim of this study was to assess the prevalence of asymptomatic carotid atherosclerotic lesions and their relation to principal risk factors. The importance of the relation between asymptomatic carotid atherosclerotic lesions, stroke, and coronary atherosclerosis has been widely discussed, but there are few transversal and longitudinal studies on a general population.
A noninvasive examination was carried out using high-resolution B-mode ultrasonography, which has been shown to be a reliable tool for epidemiological studies. We examined 630 men and 718 women aged 18-99 years (participation rate, 74.9%).
The global prevalence of carotid atherosclerosis was 25.4% in men and 26.4% in women. Intimal-medial thickening was found in 9.4% of men and 11.7% of women. Plaque prevalence was 13.3% in men and 13.4% in women; prevalence of stenotic plaques was 2.7% and 1.5%, respectively. Subjects aged < or = 39 years showed a very low prevalence of any asymptomatic carotid atherosclerotic lesions. In the multiple logistic regression, the analysis of subjects aged > or = 40 years showed a positive significant association between the severity of carotid atherosclerotic lesions (plaques and stenosis) and age (p < 0.001), systolic blood pressure (p < 0.01), cigarette smoking (p < 0.0001), and the protective effect of high density lipoprotein cholesterol (p < 0.037). This analysis did not provide evidence of a clear-cut association between risk factors and intimal-medial thickening.
This population study shows the high prevalence of asymptomatic carotid atherosclerotic lesions in a general population (approximately 25% of adults) and its relation with the classic risk factors. It emphasizes the value of ultrasonography in the detection of early atherosclerotic lesions.
本研究旨在评估无症状性颈动脉粥样硬化病变的患病率及其与主要危险因素的关系。无症状性颈动脉粥样硬化病变、中风和冠状动脉粥样硬化之间关系的重要性已得到广泛讨论，但针对普通人群的横向和纵向研究较少。
采用高分辨率B型超声进行无创检查，该方法已被证明是流行病学研究的可靠工具。我们对630名年龄在18 - 99岁的男性和718名女性进行了检查（参与率为74.9%）。
男性颈动脉粥样硬化的总体患病率为25.4%，女性为26.4%。男性内膜中层增厚的发生率为9.4%，女性为11.7%。男性斑块患病率为13.3%，女性为13.4%；狭窄斑块的患病率分别为2.7%和1.5%。年龄≤39岁的受试者任何无症状性颈动脉粥样硬化病变的患病率都非常低。在多元逻辑回归分析中，对年龄≥40岁的受试者进行分析发现，颈动脉粥样硬化病变（斑块和狭窄）的严重程度与年龄（p < 0.001）、收缩压（p < 0.01）、吸烟（p < 0.0001）以及高密度脂蛋白胆固醇的保护作用（p < 0.037）之间存在显著正相关。该分析未提供危险因素与内膜中层增厚之间存在明确关联的证据。
这项人群研究表明普通人群中无症状性颈动脉粥样硬化病变的患病率较高（约占成年人的25%）及其与经典危险因素的关系。它强调了超声检查在早期动脉粥样硬化病变检测中的价值。
