饮酒对冠心病高血压患者心血管疾病死亡和全因死亡风险的影响研究

摘要

Objective:To investigate the influence of the drinking in cardiovascular disease mortality (CVDM) and all-cause mortality(ACM) risk in patients with coronary heart disease,analyze whether had synergistic effect in the risk of the CVDM and ACM for the drinking and coronary heart disease.Method:5000 patients with coronary heart disease admitted to our hospital from January 2001 to December 2011 were selected. The demographic information, drinking and personal history of disease data were collected,the CVDM and ACM of the patients were followed up and recorded.The influence of drinking indexes in CVDM and ACM risk in patients with coronary heart disease were analyzed using the COX proportional hazards model.Result:The average follow-up time was 5.7 years,totally follow-up was 46 157.9 person years.ACM 1257 people,including 655 cases of CDVM in the time of follow-up period.The results of the COX proportional hazards model showed that:(1)Drinking could increase the risk of CVDM and ACM in coronary heart disease patients(RR=1.235 and 1.392).(2)In the aspect of the CVDM and ACM risk:daily drinking amount >10 branch was higher than 1 branch to 10 branches,the cumulative amount of drinking≥20 package year was higher than the 0.1-19 package year,drinking duration >35 years was higher than 1 year to 35 years,started drinking age≤20 years old was higher than > 20 years old,the differences were statistically significant(P<0.05).(3)When the SBP≥160 mm Hg,DBP≥100 mm Hg, PP≥70 mm Hg or≥level 2 coronary heart disease and the cumulative amount of drinking≥20 packages year, the CVDM risk respectively were(RR=2.352,2.633,2.254,2.336);ACM risk respectively were (RR=3.092, 2.346,1.936,2.018).Conclusion:Drinking can increase the risk of CVDM and ACM in coronary heart disease patients,and has a dose response relationship.Blood pressure and drinking elevated at the same time can further increase the risk.%目的：探讨饮酒对冠心病高血压患者心血管疾病死亡（CVDM）和全因死亡（ACM）风险的影响，分析饮酒量和血压同时升高对冠心病高血压患者死亡和全因死亡风险是否存在协同作用。方法：选取2001年1月-2011年12月本院诊治的冠心病高血压患者5000例。收集人口统计学信息、饮酒信息及个人疾病史等资料，随访记录患者的CVDM和ACM。采用COX比例风险模型分析饮酒指标对冠心病高血压患者CVDM和ACM风险的影响。结果：平均随访5.7年，总随访46157.9人年，随访期间ACM 1257人，其中CDVM 655人。COX比例风险模型结果显示：（1）饮酒能增加冠心病高血压患者CVDM和ACM风险（RR=1.235）和（RR=1.392）；（2）在CVDM风险和ACM发生风险方面，每日饮酒>10支大于1~10支，饮酒量≥20盅年大于0.1~19盅年，饮酒年限>35年大于1~35年，开始饮酒年龄≤20岁大于>20岁，差异均有统计学意义（P<0.05）；（3）当SBP≥160 mm Hg、DBP≥100 mm Hg、PP≥70 mm Hg或2级及以上冠心病高血压且累积饮酒量≥20盅年患者的CVDM风险分别为（RR=2.352、2.633、2.254、2.336）；ACM风险分别为（RR=3.092、2.346、1.936、2.018）。结论：饮酒可增加冠心病高血压患者CVDM和ACM风险，风险的大小与饮酒量和饮酒年限呈剂量反应关系；血压和饮酒量同时升高可进一步增加此风险。