Paraskevas Kosmas I, Hamilton George, Mikhailidis Dimitri P
Department of Clinical Biochemistry, Vascular Disease Prevention Clinic, Royal Free Hospital, London, UK.
Neurol Res. 2008 Jun;30(5):523-30. doi: 10.1179/174313208X289525.
To elucidate the clinical relevance of carotid bruits.
A search using PubMed was performed using the terms: 'carotid bruit', 'stroke', 'cerebrovascular symptoms', 'carotid artery stenosis' and 'carotid artery disease' in various combinations. The reference lists of the gathered reports were also considered.
Current evidence shows that a carotid bruit is a useful clinical sign with a high specificity (> 90%) for the detection of carotid artery stenosis. The negative predictive value (> 90%), as well as the accuracy (> 90%), of this inexpensive method, are additional advantages. The low sensitivity (< 30%) and low positive predictive values (< 30%) of carotid auscultation are its main disadvantages. A carotid bruit is also a useful indicator of systemic atherosclerosis. Carotid bruits are also associated with a higher prevalence of vascular risk factors.
Carotid auscultation is a useful and inexpensive diagnostic tool that should be included as part of a general physical examination. Its clinical relevance in terms of carotid disease, however, needs to be verified by further investigation (e.g. ultrasonography). Since carotid bruits are predictors of systemic atherosclerosis, their detection provides an opportunity to initiate further investigations and preventive measures.
阐明颈动脉杂音的临床相关性。
使用PubMed进行检索，检索词为：“颈动脉杂音”、“中风”、“脑血管症状”、“颈动脉狭窄”和“颈动脉疾病”的各种组合。还查阅了所收集报告的参考文献列表。
目前的证据表明，颈动脉杂音是一种有用的临床体征，对检测颈动脉狭窄具有较高的特异性（>90%）。这种廉价方法的阴性预测值（>90%）以及准确性（>90%）是额外的优势。颈动脉听诊的低敏感性（<30%）和低阳性预测值（<30%）是其主要缺点。颈动脉杂音也是全身性动脉粥样硬化的一个有用指标。颈动脉杂音还与血管危险因素的较高患病率相关。
颈动脉听诊是一种有用且廉价的诊断工具，应作为一般体格检查的一部分。然而，其在颈动脉疾病方面的临床相关性需要通过进一步研究（如超声检查）来验证。由于颈动脉杂音是全身性动脉粥样硬化的预测指标，对其检测为启动进一步检查和预防措施提供了机会。
