Ellis M R, Greenhalgh R M
J Vasc Surg. 1987 Jun;5(6):869-73. doi: 10.1067/mva.1987.avs0050869.
One hundred forty-nine consecutive patients who had peripheral arterial disease (PAD) with clinically audible asymptomatic bruits were studied. Sixty-two of these patients were age- and sex-matched with 62 PAD patients in whom no bruits were detected. The PAD was demonstrated by angiography or by the 1-minute exercise test. Clinical assessment was performed every 6 months and oculoplethysmography and carotid phonoangiography (OPG/CPA) were performed every year. Angiography and reconstructive surgery were performed only if symptoms of transient ischemic attack (TIA) or stroke occurred. Life-table analysis revealed that over a 5.5-year follow-up, 32% of 211 PAD patients were expected to die. In the control study 45% of bruit patients and 32% of control patients were expected to die (no significant difference). Myocardial infarction accounted for 59% of deaths in the bruit group compared with 28% in the control group (no significant difference). TIA occurred more commonly in the bruit group (26.5%) than in the controls (6%) (p less than 0.02). However, stroke without warning occurred in 9% of bruit patients compared with 8% of controls (no significant difference). It is concluded that for asymptomatic carotid bruit it is safe to wait for the onset of symptoms before angiography and corrective reconstructive surgery.
对149例患有外周动脉疾病（PAD）且临床上可闻及无症状杂音的连续患者进行了研究。其中62例患者在年龄和性别上与62例未检测到杂音的PAD患者相匹配。通过血管造影或1分钟运动试验证实存在PAD。每6个月进行一次临床评估，每年进行眼体积描记法和颈动脉血管音造影（OPG/CPA）。仅在出现短暂性脑缺血发作（TIA）或中风症状时才进行血管造影和重建手术。寿命表分析显示，在5.5年的随访中，211例PAD患者中有32%预计死亡。在对照研究中，有杂音患者中有45%预计死亡，对照组患者中有32%预计死亡（无显著差异）。杂音组中因心肌梗死导致的死亡占59%，而对照组为28%（无显著差异）。TIA在杂音组中比对照组更常见（26.5%对6%）（p<0.02）。然而，无预警的中风在有杂音患者中占9%，对照组为8%（无显著差异）。结论是，对于无症状的颈动脉杂音，在进行血管造影和矫正性重建手术前等待症状出现是安全的。
