Crouse J R, Toole J F, McKinney W M, Dignan M B, Howard G, Kahl F R, McMahan M R, Harpold G H
Department of Medicine, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, N.C. 27103.
Stroke. 1987 Nov-Dec;18(6):990-6. doi: 10.1161/01.str.18.6.990.
We related risk factors, cardiovascular symptoms, and coronary status to the extent of extracranial carotid atherosclerosis as measured by B-mode ultrasonography in 376 volunteers hospitalized for elective coronary angiography. In a first analysis, we correlated risk factors and cardiovascular symptoms with carotid atherosclerosis. Univariate analysis showed that relations between many continuous risk factors and carotid atherosclerosis were graded and consistent for men and women. Multivariate analysis identified 6 significant variables (age, hypertension, pack-years smoked, and inversely, plasma concentrations of high density lipoprotein cholesterol and uric acid, and Framingham Type A score) that together accounted for 35% of the variability in extent of carotid atherosclerosis. In a second multivariate analysis, addition of coronary status (presence or absence of coronary stenosis as evaluated by coronary angiography) to the roster of candidate independent variables produced a new equation that accounted for an additional 5% of the variability in carotid atherosclerosis extent. Although much of the variability in extent of carotid atherosclerosis remains unexplained, these data define an association between coronary and carotid atherosclerosis that depends partly on shared exposure of both arteries to the same risk factors. They are also consistent with the concept that as yet undiscovered risk factors and/or genetic (e.g., arterial wall) factors common to both arterial beds also contribute to the relation between coronary and carotid atherosclerosis in human beings.
我们将376名因择期冠状动脉造影而住院的志愿者的危险因素、心血管症状和冠状动脉状况与通过B型超声测量的颅外颈动脉粥样硬化程度进行了关联分析。在首次分析中，我们将危险因素和心血管症状与颈动脉粥样硬化进行了关联。单变量分析显示，许多连续危险因素与颈动脉粥样硬化之间的关系呈分级状态，且男性和女性一致。多变量分析确定了6个显著变量（年龄、高血压、吸烟包年数，以及与之呈负相关的高密度脂蛋白胆固醇血浆浓度、尿酸和弗雷明汉A型评分），这些变量共同解释了颈动脉粥样硬化程度变异的35%。在第二次多变量分析中，将冠状动脉状况（通过冠状动脉造影评估的冠状动脉狭窄的有无）添加到候选自变量列表中，得出了一个新的方程，该方程又解释了颈动脉粥样硬化程度变异的另外5%。尽管颈动脉粥样硬化程度的许多变异仍无法解释，但这些数据确定了冠状动脉和颈动脉粥样硬化之间的关联，这种关联部分取决于两条动脉共同暴露于相同的危险因素。它们也与以下概念一致，即尚未发现的危险因素和/或两个动脉床共有的遗传（如动脉壁）因素也促成了人类冠状动脉和颈动脉粥样硬化之间的关系。
