Alexandrova N A, Gibson W C, Norris J W, Maggisano R
Division of Vascular Surgery, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
J Vasc Surg. 1996 Apr;23(4):645-9. doi: 10.1016/s0741-5214(96)80045-0.
The goal of the study was to assess the prevalence and severity of symptomatic and asymptomatic carotid artery disease in patients with peripheral vascular disease (PVD).
Consecutive patients with clinically and Doppler scanning-proven PVD (category 1 or greater) underwent prospective screening for the presence of carotid atherosclerosis with color-coded duplex ultrasonography. Preexisting risk factors were recorded with a standard questionnaire and included sex, age, diabetes mellitus, history of smoking, hypertension, prior stroke/transient ischemic attacks, and coronary artery disease.
Three hundred seventy-three consecutive patients were studied over 2 years. The mean age of the patients was 70 +/- 10 years; there were 223 (60%) men and 150 (40%) women; 71% of the patients had a history of smoking, 47% had coronary artery disease, 43% had hypertension, and 21% had diabetes mellitus. Two hundred eleven (57%) patients had 30% or greater carotid artery stenosis detected by carotid artery duplex scanning. Sixty-seven (32%) of these had symptoms of ischemic cerebral events, of whom 22 had potentially operable carotid artery stenoses (70% to 99%), whereas 72 of the 144 symptom-free patients had 60% to 99% stenosis. An additional 34 patients would be eligible candidates for the ongoing carotid endarterectomy trials (North American Symptomatic Carotid Endarterectomy Trial and European Carotid Surgery Trial). Although all the risk factors were associated significantly with PVD and carotid artery disease (p < 0.002), male sex and prior stroke/transient ischemic attack were the strongest predictors.
Routine carotid ultrasound screening of 373 consecutive patients with category I or greater PVD revealed that 22 patients with symptoms and 72 symptom-free patients were potential surgical candidates, representing 25% of the study cohort. An additional 34 patients were potential candidates for enrollment into the North American Symptomatic Carotid Endarterectomy Trial and European Carotid Surgery Trial.
本研究的目的是评估外周血管疾病（PVD）患者有症状和无症状颈动脉疾病的患病率及严重程度。
对临床及多普勒扫描证实为PVD（1级或更高级别）的连续患者，采用彩色编码双功超声对颈动脉粥样硬化情况进行前瞻性筛查。通过标准问卷记录既往存在的危险因素，包括性别、年龄、糖尿病、吸烟史、高血压、既往中风/短暂性脑缺血发作以及冠状动脉疾病。
在2年期间对373例连续患者进行了研究。患者的平均年龄为70±10岁；男性223例（60%），女性150例（（40%）；71%的患者有吸烟史，47%有冠状动脉疾病，43%有高血压，21%有糖尿病。通过颈动脉双功扫描检测到211例（57%）患者存在30%或更高程度的颈动脉狭窄。其中67例（32%）有缺血性脑事件症状，其中22例有潜在可手术的颈动脉狭窄（70%至99%），而144例无症状患者中有72例有60%至99%的狭窄。另外34例患者符合正在进行的颈动脉内膜切除术试验（北美症状性颈动脉内膜切除术试验和欧洲颈动脉外科试验）的入选标准。尽管所有危险因素均与PVD和颈动脉疾病显著相关（p<0.002），但男性性别和既往中风/短暂性脑缺血发作是最强的预测因素。
对373例连续的I级或更高级别PVD患者进行常规颈动脉超声筛查发现，22例有症状患者和72例无症状患者为潜在手术候选者，占研究队列的25%。另外34例患者有资格入选北美症状性颈动脉内膜切除术试验和欧洲颈动脉外科试验。
