Schoenfeld M R, Aronow W S, Paul P
Life-Line Special Medical Services, Scarsdale, New York.
Angiology. 1988 Aug;39(8):720-4. doi: 10.1177/000331978803900803.
The authors studied by carotid duplex ultrasonography 478 unselected elderly patients (age sixty to one hundred one years, mean 82 +/- 8), in their long-term health care facility. Of these, 108 had previously experienced strokes owing to atherothrombotic brain infarcts, documented by a neurologist, and 370 had not. The degree of extracranial internal or common carotid narrowing in these patients was classified by standard Vmax Doppler criteria as 0-40%, 40-80%, and 80-100% luminal diameter reduction. The authors found that 87% of the patients had little or no carotid stenosis (0-40% luminal diameter reduction). Nevertheless, 79% of the previous strokes had occurred in these patients, and the incidence of strokes in this group was 21%. Severe, but not mild or moderate, degrees of carotid obstruction (80-100% luminal diameter reduction) were associated with a 100% stroke incidence. The authors conclude that strokes most commonly result from causes other than ischemia due to in situ severe extracranial internal or common carotid stenosis or occlusion.
作者在长期医疗保健机构中，通过颈动脉双功超声检查对478例未经挑选的老年患者（年龄60至101岁，平均82±8岁）进行了研究。其中，108例曾因动脉粥样硬化性脑梗死发生过中风，由神经科医生记录在案，370例未曾发生过中风。根据标准Vmax多普勒标准，将这些患者颅外颈内动脉或颈总动脉狭窄程度分为管腔直径减少0 - 40%、40 - 80%和80 - 100%。作者发现，87%的患者几乎没有或没有颈动脉狭窄（管腔直径减少0 - 40%）。然而，79%的既往中风发生在这些患者中，该组中风发生率为21%。严重（而非轻度或中度）程度的颈动脉阻塞（管腔直径减少80 - 100%）与100%的中风发生率相关。作者得出结论，中风最常见的原因并非是由于原位严重颅外颈内动脉或颈总动脉狭窄或闭塞导致的缺血。
