医院人群中的中风与酒精摄入量。一项病例对照研究。

Stroke and alcohol intake in a hospital population. A case-control study.

作者信息

Beghi E, Boglium G, Cosso P, Fiorelli G, Lorini C, Mandelli M, Bellini A

机构信息

Clinica Neurologica, Ospedale San Gerardo, Monza, Italy.

出版信息

Stroke. 1995 Sep;26(9):1691-6. doi: 10.1161/01.str.26.9.1691.

DOI:10.1161/01.str.26.9.1691

PMID:7660416

Abstract

BACKGROUND AND PURPOSE

The aim of the study was to assess whether excessive alcohol intake is an independent risk factor for stroke.

METHODS

A case-control study was undertaken in 200 consecutive ischemic and hemorrhagic stroke patients and 372 age- and sex-matched control subjects (170 hospital-based and 202 community-based individuals). Data were collected through direct interview regarding demographics, risk factors for stroke, current daily alcohol consumption, and diagnosis of alcoholism. Blood was also taken to test the common biological markers of alcohol intake (erythrocyte mean cell volume, uric acid, aspartate aminotransferase, and gamma-glutamyl transferase).

RESULTS

After controlling for the most significant risk factors (antecedent strokes, hypertension, diabetes, smoking) and using hospital control subjects for reference, we determined the risk of stroke to be 2.2 (95% confidence interval [CI], 1.2 to 4.0) in moderate drinkers (men, < or = 60 g/d; women, < or = 40 g/d) and 2.9 (95% CI, 1.4 to 6.1) in heavy drinkers (men, > 60 g/d; women, > 40 g/d). The corresponding risk values obtained when we compared case subjects and external control subjects were 1.4 (95% CI, 0.8 to 2.7) and 3.0 (95% CI, 1.3 to 7.0). Even with some fluctuations across groups, the risk did not change significantly after subgroup analysis in men, patients with first-ever stroke, patients with ischemic stroke, and after exclusion of subjects with risk factors for stroke. Compared with hospital and external control subjects, stroke patients included a higher proportion of heavy drinkers (26.6% versus 20.6% versus 10.8%), alcoholics (14.6% versus 7.7% versus 2.5%), and cases with abnormal erythrocyte mean cell volume (63.0% versus 47.6% versus 34.2%) or gamma-glutamyl transferase (35.5% versus 32.4% versus 12.9%). Mean alcohol consumption was 42.2 g/d in the case subjects, 30.8 g/d in the hospital control subjects, and 23.2 g/d in the external control subjects.

CONCLUSIONS

The study indicates that alcohol can be considered an independent risk factor for stroke in Italy.

摘要

背景与目的

本研究旨在评估过量饮酒是否为中风的独立危险因素。

方法

对200例连续性缺血性和出血性中风患者以及372例年龄和性别匹配的对照者（170例基于医院的个体和202例基于社区的个体）进行了一项病例对照研究。通过直接访谈收集了有关人口统计学、中风危险因素、当前每日饮酒量以及酒精中毒诊断的数据。还采集了血液以检测酒精摄入的常见生物学标志物（红细胞平均细胞体积、尿酸、天冬氨酸转氨酶和γ-谷氨酰转移酶）。

结果

在控制了最显著的危险因素（既往中风、高血压、糖尿病、吸烟）并以医院对照者作为参照后，我们确定中度饮酒者（男性，≤60克/天；女性，≤40克/天）中风风险为2.2（95%置信区间[CI]，1.2至4.0），重度饮酒者（男性，>60克/天；女性，>40克/天）中风风险为2.9（95%CI，1.4至6.1）。当我们比较病例组与外部对照者时，相应的风险值分别为1.4（95%CI，0.8至2.7）和3.0（95%CI，1.3至7.0）。即使各亚组之间存在一些波动，但在男性、首次中风患者、缺血性中风患者亚组分析以及排除有中风危险因素的受试者后，风险并未显著改变。与医院对照者和外部对照者相比，中风患者中重度饮酒者（分别为26.6%、20.6%和10.8%）、酒精中毒者（分别为14.6%、7.7%和2.5%）以及红细胞平均细胞体积异常（分别为63.0%、47.6%和34.2%）或γ-谷氨酰转移酶异常（分别为35.5%、32.4%和12.9%）的病例所占比例更高。病例组的平均饮酒量为42.2克/天，医院对照者为30.8克/天，外部对照者为23.2克/天。