Gentilello L M, Rivara F P, Donovan D M, Villaveces A, Daranciang E, Dunn C W, Ries R R
University of Washington School of Medicine, Department of Surgery, Harborview Injury Prevention and Research Center, Seattle 98104, USA.
J Trauma. 2000 Jan;48(1):108-14. doi: 10.1097/00005373-200001000-00018.
Male patients constitute such a large proportion of trauma patients that most studies of alcohol problems in trauma patients have been carried out with clinical data largely or totally contributed by male patients. It may be incorrect to assume that the nature of alcoholism in women and men is identical, or that the size of the problem among women is small, eliminating the need to specifically study female patients. The purpose of this study was to perform a gender-based comparison of alcohol problems in trauma patients.
Admitted injured patients underwent routine screening, including a blood alcohol concentration, serum gamma-glutamyl transpeptidase, and the Short Michigan Alcohol Screening Test. A random sample of screen positive women and men underwent a comprehensive alcohol use and psychosocial assessment, and the results were compared by gender.
The screen-positive rate was higher for men, 51% versus 34% (p < 0.01). However, screen-positive women and men had similar problem severity as reflected by mean blood alcohol concentration (162 mg/dL vs. 142 mg/dL, p = 0.16) and Short Michigan Alcohol Screening Test scores (4.6 vs. 5.0, p = 0.32). The Alcohol Use Disorders Identification Test, NIMH-DIS, and Severity of Alcohol Dependence Data form showed that female trauma patients with alcohol problems have the same severity of dependence symptoms as men. However, women were significantly more likely to have liver dysfunction, depression, psychological distress, and recent physical, emotional, or sexual abuse.
Alcohol problems are more common in male trauma patients, but women with alcohol problems are just as severely impaired, have at least as many adverse consequences of alcohol use as their male counterparts, and have more evidence of alcohol-related physical and psychological harm.
男性患者在创伤患者中占比很大，以至于大多数关于创伤患者酒精问题的研究都是基于主要或完全由男性患者提供的临床数据开展的。认为女性和男性酒精中毒的性质相同，或者认为女性中该问题的规模较小，从而无需专门研究女性患者，这种假设可能是不正确的。本研究的目的是对创伤患者的酒精问题进行基于性别的比较。
入院的受伤患者接受常规筛查，包括血液酒精浓度、血清γ-谷氨酰转肽酶和密歇根酒精筛选测试简表。对筛查呈阳性的女性和男性进行随机抽样，进行全面的酒精使用和心理社会评估，并按性别比较结果。
男性的筛查阳性率更高，分别为51%和34%（p<0.01）。然而，筛查呈阳性的女性和男性的问题严重程度相似，平均血液酒精浓度（162mg/dL对142mg/dL，p=0.16）和密歇根酒精筛选测试简表得分（4.6对5.0，p=0.32）反映了这一点。酒精使用障碍识别测试、美国国立精神卫生研究所诊断访谈表和酒精依赖严重程度数据表单显示，有酒精问题的女性创伤患者与男性的依赖症状严重程度相同。然而，女性更有可能出现肝功能障碍、抑郁、心理困扰以及近期身体、情感或性虐待。
酒精问题在男性创伤患者中更为常见，但有酒精问题的女性受损程度同样严重，饮酒带来的不良后果至少与男性相当，并且有更多酒精相关身心伤害的证据。
