Salenius J P, Haapanen A, Harju E, Jokela H, Riekkinen H
Department of Surgery and Clinical Sciences, University of Tampere, Finland.
Eur J Vasc Surg. 1989 Jun;3(3):271-7. doi: 10.1016/s0950-821x(89)80094-5.
During a fourteen-year-period 257 patients underwent carotid endarterectomy in an unselected population of 700,000 inhabitants. The incidence of haemodynamically significant restenosis was 13.5% in 133 vessels in 116 patients studied by duplex scanning 28 to 209 months following carotid endarterectomy. The most striking differences between patent and restenosed cases were in serum cholesterol, triglyceride and HDL-cholesterol levels. The patients with a long-term low cholesterol (less than 6.5 mmol/l), low triglyceride (less than 1.42 mmol/l) and high HDL cholesterol (greater than 1.0 mmol/l) levels had significantly less high grade restenosis (P less than 0.05). Apolipoprotein A-I and B had no significant effect, but if the lowest limit of normal apolipoprotein A-I level was considered as 1.27 g/l the difference was significant. The frequency of a high-grade restenosis in patients with diabetes mellitus and coronary heart disease was not significantly increased, but supports the view that these are risk factors in the development of atherosclerotic changes in an operated carotid artery. The incidence of recurrent stenosis appears to be unrelated to hypertension, claudication, obesity, smoking, operative factors or to the indication for surgery. Men were more prone than women to get a high-grade restenosis. Postoperative treatment with acetylsalicylic acid was most effective, the incidence was only half of that expected, whereas the anticoagulants or a combination of acetylsalicylic acid and dipyridamole were of no benefit. Haematocrit, RBC, platelet count and thrombocrit were contradictory.
在14年期间，在一个70万居民的未经过筛选的人群中，有257例患者接受了颈动脉内膜切除术。在颈动脉内膜切除术后28至209个月，对116例患者的133条血管进行双功扫描研究，血流动力学显著再狭窄的发生率为13.5%。通畅和再狭窄病例之间最显著的差异在于血清胆固醇、甘油三酯和高密度脂蛋白胆固醇水平。长期胆固醇水平低（低于6.5 mmol/l）、甘油三酯水平低（低于1.42 mmol/l）和高密度脂蛋白胆固醇水平高（高于1.0 mmol/l）的患者，高级别再狭窄明显较少（P小于0.05）。载脂蛋白A-I和B没有显著影响，但如果将正常载脂蛋白A-I水平的最低限视为1.27 g/l，则差异显著。糖尿病和冠心病患者高级别再狭窄的发生率没有显著增加，但支持这些是手术颈动脉发生动脉粥样硬化改变的危险因素这一观点。再狭窄的发生率似乎与高血压、跛行、肥胖、吸烟、手术因素或手术指征无关。男性比女性更容易发生高级别再狭窄。术后用乙酰水杨酸治疗最有效，发生率仅为预期的一半，而抗凝剂或乙酰水杨酸与双嘧达莫联合使用则没有益处。血细胞比容、红细胞、血小板计数和血小板压积情况相互矛盾。
