Norris J W, Zhu C Z, Bornstein N M, Chambers B R
Stroke Research Unit, Sunnybrook Health Science Centre, University of Toronto, Canada.
Stroke. 1991 Dec;22(12):1485-90. doi: 10.1161/01.str.22.12.1485.
We sought to determine the risks of stroke, myocardial ischemia, and vascular death in patients with asymptomatic carotid stenosis.
Six hundred ninety-six patients with asymptomatic carotid stenosis referred to the Doppler laboratory were followed prospectively for a mean time of 41 months. These patients were studied both clinically and by carotid Doppler ultrasound, including evaluation of the effect of stroke risk factors.
Transient ischemic attacks occurred in 75 patients and stroke in 29, while 132 had ischemic cardiac events. Five patients died from stroke and 59 from cardiac causes. Annual stroke rate was 1.3% in patients with carotid stenosis less than or equal to 75% and 3.3% in those with stenosis greater than 75%. Ipsilateral stroke rate was 2.5% in patients with greater than 75% carotid stenosis. Annual cardiac event rate was 8.3% and death rate 6.5% in patients with severe carotid stenosis.
With carotid stenosis less than or equal to 75%, the stroke rate is negligible (1.3% annually) whereas the combined risk of cardiac ischemia and vascular death is as high as 9.9%. With stenosis greater than 75%, combined transient ischemic attack and stroke rate is 10.5% per year, with 75% of events ipsilateral to the stenosed artery.
我们试图确定无症状性颈动脉狭窄患者发生中风、心肌缺血和血管性死亡的风险。
对转诊至多普勒实验室的696例无症状性颈动脉狭窄患者进行了平均41个月的前瞻性随访。对这些患者进行了临床研究，并通过颈动脉多普勒超声检查，包括评估中风危险因素的影响。
75例患者发生短暂性脑缺血发作，29例发生中风，132例发生缺血性心脏事件。5例患者死于中风，59例死于心脏原因。颈动脉狭窄小于或等于75%的患者年中风率为1.3%，狭窄大于75%的患者年中风率为3.3%。颈动脉狭窄大于75%的患者同侧中风率为2.5%。重度颈动脉狭窄患者的年心脏事件发生率为8.3%，死亡率为6.5%。
颈动脉狭窄小于或等于75%时，中风率可忽略不计（每年1.3%），而心肌缺血和血管性死亡的综合风险高达9.9%。狭窄大于75%时，短暂性脑缺血发作和中风的综合发生率为每年10.5%，其中75%的事件发生在狭窄动脉的同侧。
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