黄鹏王达平刘榴余晓仪李福球

·论 著·

长期危险饮酒对酒精依赖者心血管功能的影响☆

黄鹏*△王达平*刘榴*余晓仪*李福球△

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（P＞0.05）。长期危险饮酒组患者左心射血分数低于对照组（P＜0.01），左房主动排空分数高于非长期危险饮酒组及对照组（P＜0.05），肱动脉内皮舒张功能、颈动脉内膜中层厚度低于对照组（P＜0.05）。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（P＜0.05）。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。

酒精依赖 危险饮酒 心血管功能异常

【Abstract】Objective To identify the effect of long hazardous drinking on cardiovascular function and cardiovascular 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 carotid artery brachial artery ultrasonography measurement data were compared between the three groups.The high risk factors 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 distribution of blood lipid data among GroupⅠ，Ⅱand 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 Group Ⅰwas significantly lower than that in control group（P＜0.01）.In the case group，the duration of drinking alcohol was negatively associated with LAPEF（r=-0.246，P=0.014）and LAAEF（r=0.239，P=0.016）.The average daily alcohol consumption 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 cardiovascular 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 dependent patient.

【Key words】Alcohol Dependence Hazardous Drinking Cardiovascular Abnormalities

酒精依赖是一种慢性复发性脑病，患者由于长期过量饮酒引起中枢神经系统损伤，主要表现为对饮酒的渴求以及戒断症状，导致躯体、心理等多方面严重损害，其中酒精依赖对心血管功能的影响是目前研究热点［1-2］。……