长期危险饮酒对酒精依赖者心血管功能的影响

目的探讨长期危险饮酒与心血管功能变化的关系,并分析长期危险饮酒对酒精依赖患者心血管意外发生的影响。方法纳入酒精依赖患者72例,按WHO饮酒分类标准将危险饮酒且超过10年的患者分为长期危险饮酒组(52例),其他患者为非长期危险饮酒组(20例);并纳入无习惯性饮酒嗜好的健康体检者75名为对照组。采用全自动生化分析仪检测被试血脂水平,彩色多普勒超声测量心脏功能以及颈、肱动脉内皮功能,并于患者出院后1年内电话随访其心血管意外发生情况。结果三组血脂各指标差异均无统计学意义(P0.05)。长期危险饮酒组患者左心射血分数低于对照组(P0.01),左房主动排空分数高于非长期危险饮酒组及对照组(P0.05),肱动脉内皮舒张功能、颈动脉内膜中层厚度低于对照组(P0.05)。所有患者饮酒年限与左房被动排空分数(r=-0.246,P=0.014)、左房主动排空分数(r=-0.239,P=0.016)呈负相关,平均每日饮酒量与左心射血分数呈正相关(r=0.256,P=0.010),与肱动脉内皮舒张功能呈负相关(r=-0.256,P=0.010)。多因素logistic回归分析示,酒精依赖患者发生心血管意外与年龄(OR=1.102,95%CI:1.020~1.191)、长期危险饮酒(OR=1.334,95%CI:1.060~1.678)有关联(P0.05)。结论长期危险饮酒可致酒精依赖患者的左室舒张功能及血管内皮功能受损,是导致酒精依赖患者发生心血管意外的独立危险因素。

Influence of long hazardous drinking on cardiovascular function among alcohol dependent patients

Objective To identify the effect of long hazardous drinking on cardiovascular function and cardiovascu?lar abnormalities among alcohol dependent patients. Methods A follow-up survey was conducted, 72 potential patients who were diagnosed as having alcohol dependence were recruited into case group and 75 staff who underwent routine health examination were subjected into control group. Furthermore, 52 patients were subdivided into long hazardous drinking group (GroupⅠ) according to the classification of alcohol consumption published by WHO. The rest patients in the case group were considered as not long hazardous drinkers (GroupⅡ). The blood lipid data, echocardiography and ca?rotid artery brachial artery ultrasonography measurement data were compared between the three groups. The high risk fac?tors for cardiovascular abnormalities among alcohol dependence patients were analyzed. And one year after discharge, telephone follow-up method was used to obtain the incidence of cardiovascular accident among patients. Results The dis?tribution of blood lipid data among GroupⅠ, Ⅱ and control group were not significantly different (P>0.05). The LVEF score in GroupⅠwas significantly lower than that in control group (P<0.01). The LAAEF score in GroupⅠwas signifi? cantly higher than that in control group and that in the GroupⅡ(P<0.05). While the FDM and IMT score in the GroupⅠwas significantly lower than that in control group (P<0.01). In the case group, the duration of drinking alcohol was neg?atively associated with LAPEF (r=-0.246, P=0.014) and LAAEF (r=0.239, P=0.016). The average daily alcohol consump?tion was positively associated with LVEF (r=0.256, P=0.010), while negatively correlated with FMD (r=-0.256,P=0.010). Multivariate logistic regression analysis showed that long hazardous drinking was an independent risk factor for cardiovas?cular abnormalities (OR=1.334, 95%CI: 1.060~1.678). Conclusion Long hazardous drinking can reduce left ventricular diastolic and vascular endothelial function. It is an independent risk factor for cardiovascular abnormalities in alcohol de?pendent patient.