Singh R, Cohen S N, Krupp R, Abedi A G
Department of Neurology, West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA, USA.
J Stroke Cerebrovasc Dis. 1998 Sep-Oct;7(5):352-7. doi: 10.1016/s1052-3057(98)80054-2.
To evaluate racial differences in extracranial carotid atherosclerosis and vascular risk factors in patients with symptomatic cerebrovascular disease.
There are conflicting data on racial differences in certain vascular risk factors and prevalence of large-vessel versus small-vessel disease in patients with stroke.
We prospectively studied 211 consecutive patients admitted to our stroke service. There were 71 African-American, 114 Caucasian, 20 Hispanic, and 6 other patients. Extracranial vascular stenosis was assessed with a carotid duplex (CD) scan. Risk factors monitored included race, age, history of hypertension (HTN), diabetes mellitus (DM), prior stroke, hyperlipidemia, smoking, cardiac disease (congestive heart failure, atrial fibrillation), and family history of stroke. Cholesterol and triglyceride blood levels, and computed tomography/magnetic resonance imaging results were obtained in most cases.
Significant differences were found between Caucasians and African-Americans in several variables. Caucasians had more frequent hypertriglyceridemia and a higher rate of cardiac disease. African-Americans had more frequent lacunar infarcts. There was a trend toward decreased risk of CD scan abnormality, and more HTN and prior stroke in African-Americans. There were no differences in the presence of DM, both HTN and DM, abnormal cholesterol (including high- and low-density lipoprotein) values, and smoking history. Except for the difference in lacunar infarction, there were no differences in the type of stroke.
Our data indicate a greater risk of cardiac disease and hypertriglyceridemia in Caucasians with cerebrovascular disease. There was a trend for Caucasians to have more extracranial carotid disease, and a trend for African-Americans to have more hypertension and prior stroke, although the difference did not reach significance. Consistent with prior racial studies, we found African-Americans to have more lacunar strokes than Caucasians.
评估有症状脑血管疾病患者颅外颈动脉粥样硬化及血管危险因素的种族差异。
关于某些血管危险因素的种族差异以及中风患者大血管与小血管疾病的患病率，存在相互矛盾的数据。
我们对连续收治入我院卒中科的211例患者进行了前瞻性研究。其中有71例非裔美国人、114例白种人、20例西班牙裔和6例其他患者。采用颈动脉双功超声（CD）扫描评估颅外血管狭窄情况。监测的危险因素包括种族、年龄、高血压病史（HTN）、糖尿病（DM）、既往中风史、高脂血症、吸烟、心脏病（充血性心力衰竭、心房颤动）以及中风家族史。大多数病例均获取了胆固醇和甘油三酯的血液水平以及计算机断层扫描/磁共振成像结果。
白种人和非裔美国人在几个变量上存在显著差异。白种人高甘油三酯血症更为常见，心脏病发生率更高。非裔美国人腔隙性梗死更为常见。非裔美国人CD扫描异常风险有降低趋势，且高血压和既往中风发生率更高。糖尿病、高血压合并糖尿病、胆固醇异常（包括高密度脂蛋白和低密度脂蛋白）值以及吸烟史方面无差异。除腔隙性梗死差异外，中风类型无差异。
我们的数据表明，患有脑血管疾病的白种人患心脏病和高甘油三酯血症的风险更大。白种人颅外颈动脉疾病有增多趋势，非裔美国人高血压和既往中风有增多趋势，尽管差异未达到显著水平。与先前的种族研究一致，我们发现非裔美国人的腔隙性中风比白种人更多。
