Juvela S, Hillbom M, Numminen H, Koskinen P
Department of Neurosurgery, Helsinki University Hospital, Finland.
Stroke. 1993 May;24(5):639-46. doi: 10.1161/01.str.24.5.639.
Aneurysmal subarachnoid hemorrhage is a serious disease despite recent improvements in medical and surgical treatment. Hence, identification of modifiable risk factors for subarachnoid hemorrhage is important.
We compared the smoking and drinking habits of 278 consecutive patients with aneurysmal subarachnoid hemorrhage, aged 15-60 years (145 men and 133 women) with those of 314 hospitalized control patients (164 men and 150 women) who did not differ in regard to age, day of onset of symptoms, and acuteness of disease onset.
Multiple logistic regression analysis showed that recent alcohol intake and smoking, but not hypertension, were significant independent risk factors for hemorrhage. After adjustment for age, hypertension, and smoking status, men who had consumed 1-40, 41-120, or > 120 g of alcohol within the 24 hours preceding the onset of illness had a relative risk of hemorrhage of 0.3 (95% confidence interval [CI], 0.1-0.8), 2.5 (95% CI, 1.1-5.5), and 4.5 (95% CI, 1.5-12.9), respectively, compared with men who had consumed 0 g. Women who had consumed 1-40 or > 40 g of alcohol had a risk of hemorrhage of 0.4 (95% CI, 0.2-0.8) and 6.4 (95% CI, 2.3-17.9), respectively, compared with women without use of alcohol. Heavily smoking (> 20 cigarettes per day) men and currently smoking women had adjusted relative risks of hemorrhage of 7.3 (95% CI, 3.8-14.3) and 2.1 (95% CI, 1.2-3.6), respectively, compared with men who had never smoked and with women who were not current smokers. Higher levels of erythrocyte mean corpuscular volume in patients with subarachnoid hemorrhage than in control subjects supported the notion of different smoking and drinking habits.
Recent heavy alcohol intake and current smoking seem to be independent risk factors for aneurysmal subarachnoid hemorrhage.
尽管近年来医学和外科治疗有所改进，但动脉瘤性蛛网膜下腔出血仍是一种严重疾病。因此，识别蛛网膜下腔出血的可改变危险因素很重要。
我们比较了278例年龄在15 - 60岁的连续性动脉瘤性蛛网膜下腔出血患者（145例男性和133例女性）与314例住院对照患者（164例男性和150例女性）的吸烟和饮酒习惯，这些对照患者在年龄、症状发作日和疾病发作的急性程度方面无差异。
多因素逻辑回归分析显示，近期饮酒和吸烟而非高血压是出血的显著独立危险因素。在对年龄、高血压和吸烟状况进行调整后，发病前24小时内摄入1 - 40克、41 - 120克或> 120克酒精的男性，与摄入0克酒精的男性相比，出血的相对风险分别为0.3（95%置信区间[CI]，0.1 - 0.8）、2.5（95% CI，1.1 - 5.5）和4.5（95% CI，1.5 - 12.9）。与未饮酒的女性相比，摄入1 - 40克或> 40克酒精的女性出血风险分别为0.4（95% CI，0.2 - 0.8）和6.4（95% CI，2.3 - 17.9）。与从不吸烟的男性和非当前吸烟者的女性相比，重度吸烟（> 20支/天）的男性和当前吸烟的女性调整后的出血相对风险分别为7.3（95% CI，3.8 - 14.3）和2.1（95% CI，1.2 - 3.6）。蛛网膜下腔出血患者的红细胞平均体积水平高于对照受试者，这支持了不同吸烟和饮酒习惯的观点。
近期大量饮酒和当前吸烟似乎是动脉瘤性蛛网膜下腔出血的独立危险因素。
