Meissner I, Wiebers D O, Whisnant J P, O'Fallon W M
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
JAMA. 1987 Nov 20;258(19):2704-7.
The purpose of this retrospective study was to determine the long-term prognosis of patients with asymptomatic pressure-significant (hemodynamically significant) internal carotid system lesions. Of 640 neurologically asymptomatic patients, 292 had pressure-significant internal carotid artery occlusive lesions as determined by ocular pneumoplethysmography, while 348 had a carotid bruit only without a pressure-significant lesion. The annual stroke rate for the first three years on a Kaplan-Meier life-table basis was 3.4% and 1.5% in the abnormal and normal ocular pneumoplethysmography groups, respectively, as compared with a rate of 0.5% in a normal age- and sex-matched population. The annual total event rate (transient ischemic attack and stroke) was 5.2% in the abnormal vs 2.3% in the normal group, with 56% of all events ipsilateral to the ocular pneumoplethysmography abnormality. These results indicate that patients with asymptomatic pressure-significant carotid system occlusive lesions are at greater risk for stroke than a normal ocular pneumoplethysmography group (twofold) and a general population (sevenfold).
这项回顾性研究的目的是确定无症状性有压力意义（血流动力学显著）的颈内动脉系统病变患者的长期预后。在640例无神经系统症状的患者中，经眼体积描记法测定，292例有压力意义的颈内动脉闭塞性病变，而348例仅有颈动脉杂音但无压力意义的病变。根据Kaplan-Meier生存表，在前三年中，异常眼体积描记法组和正常眼体积描记法组的年卒中发生率分别为3.4%和1.5%，而年龄和性别匹配的正常人群的发生率为0.5%。异常组的年总事件发生率（短暂性脑缺血发作和卒中）为5.2%，正常组为2.3%，所有事件中有56%发生在眼体积描记法异常同侧。这些结果表明，无症状性有压力意义的颈动脉系统闭塞性病变患者发生卒中的风险高于正常眼体积描记法组（两倍）和普通人群（七倍）。
