Wang M Y, Mimran R, Mohit A, Lavine S D, Giannotta S
Department of Neurosurgery, University of Southern California, Los Angeles County General Hospital, Los Angeles, CA 90033, USA.
J Stroke Cerebrovasc Dis. 2000 Mar-Apr;9(2):64-9. doi: 10.1053/jscd.2000.0090064.
Carotid stenosis is an important, treatable cause of stroke. Several population-based studies have shown ethnic differences in the prevalence of carotid atherosclerosis. This study was performed at a large multiethnic hospital to clarify these differences.
One thousand six carotid artery ultrasounds performed by the Department of Radiology at Los Angeles County General Hospital over a 4-year period were reviewed. Patients were classified as Caucasian (n=151), Hispanic (n=515), Black (n=173), or Asian (n=167) by self-declaration and birthplace. Carotid stenosis was defined as mild (1% to 39%), moderate (40% to 59%), severe (60% to 79%), critical (80% to 99%), or total (100%).
Twenty and one-half percent of Caucasian patients had greater than 59% stenosis compared with 10.1% of Hispanics, 8.7% of Blacks, and 10.7% of Asians (P<0.001). Nine and two-tenths percent of Caucasians had greater than 79% stenosis compared with 4.3% of Hispanics, 2.9% of Blacks, and 2.8% of Asians (P<0.001). There were no significant differences in age or gender representations between ethnic groups, and the indications for ordering carotid duplex sonography also did not vary by race. Caucasians and Blacks had a higher prevalence of cardiac disease, smoking, and heavy alcohol abuse. Hispanics had higher rates of diabetes.
These results indicate that significant differences in the degree of carotid stenosis exist among ethnic groups. Caucasian patients in our series showed a statistically higher likelihood of having a severe or critical level of stenosis. These findings may have implications for the allocation of health care resources as ethnic minorities compose a greater proportion of the population.
颈动脉狭窄是中风的一个重要且可治疗的病因。多项基于人群的研究表明，颈动脉粥样硬化的患病率存在种族差异。本研究在一家大型多民族医院开展，以阐明这些差异。
回顾了洛杉矶县总医院放射科在4年期间进行的1600例颈动脉超声检查。患者根据自我申报和出生地被分类为白种人（n = 151）、西班牙裔（n = 515）、黑人（n = 173）或亚洲人（n = 167）。颈动脉狭窄被定义为轻度（1%至39%）、中度（40%至59%）、重度（60%至79%）、极重度（80%至99%）或完全闭塞（100%）。
20.5%的白种人患者狭窄程度大于59%，相比之下，西班牙裔为10.1%，黑人为8.7%，亚洲人为10.7%（P < 0.001）。9.2%的白种人狭窄程度大于79%，相比之下，西班牙裔为4.3%，黑人为2.9%，亚洲人为2.8%（P < 0.001）。不同种族之间在年龄或性别分布上没有显著差异，并且进行颈动脉双功超声检查的指征也不因种族而异。白种人和黑人患心脏病、吸烟和重度酗酒的患病率较高。西班牙裔糖尿病发病率较高。
这些结果表明，不同种族之间颈动脉狭窄程度存在显著差异。我们系列研究中的白种人患者在统计学上显示出严重或极重度狭窄的可能性更高。随着少数民族在人口中所占比例越来越大，这些发现可能对医疗资源的分配产生影响。
