中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
40期
2834-2838
,共5页
刘品明%Shailendrasing Dosieah%罗年桑%黄至斌%林永青%王景峰
劉品明%Shailendrasing Dosieah%囉年桑%黃至斌%林永青%王景峰
류품명%Shailendrasing Dosieah%라년상%황지빈%림영청%왕경봉
饮酒%卒中%病死率%相对风险%荟萃分析
飲酒%卒中%病死率%相對風險%薈萃分析
음주%졸중%병사솔%상대풍험%회췌분석
Alcohol%Stroke%Mortality%Relative risk%Meta-analysis
目的 系统评价源自于中、日、韩关于饮酒和卒中关系的前瞻性队列研究,探讨东亚男性饮酒和卒中及全因死亡的关系.方法 检索Pubmed等数据库,纳入符合入选条件的前瞻性队列研究,记录研究来源国家、研究对象例数、性别、年龄(均数或中位数及间距)、随访期限、饮酒量(g/d)、与饮酒相关的卒中或死亡相对风险(RR)及95%可信区间(CI)等.根据异质性检验结果,采用随机或固定效应模型,以RR作为评价饮酒量与缺血性卒中或出血性卒中发病率及全因死亡率的风险效应指标.结果 共纳入17项前瞻性队列研究.样本量最小1 322人,最大108 461人,9项研究报道了全因死亡;7项报道了缺血性卒中、7项报道了出血性卒中.随访期间4.1～19.0年.分层比较显示每日饮酒量≤20、21～40、41～60、＞60 g/d的各组与不饮酒者比较,缺血性卒中风险(RR及95%CI)分别为0.85(0.78～0.93;P=0.0002)、0.94(0.79～1.11;P=0.46)、1.08(0.86～1.37;P=0.50)和1.24(0.96～1.59;P=0.10);出血性卒中风险分别为0.92(0.75～1.12;P=0.40)、1.11(0.96～1.28;P=0.17)、1.20(0.92～1.56;P=0.18)和1.74(1.32～2.28;P＜0.01);全因死亡风险分别为0.83(0.75～0.91,P=0.01)、0.93(0.87～0.99,P=0.03)、1.01(0.95～1.07;P=0.86)和1.32(1.29～1.36;P＜0.01).结论 在东亚男性人群中,少量饮酒(≤20 g/d)降低缺血性卒中的风险,过量饮酒使卒中(尤其是出血性卒中)、全因死亡的风险明显增加.适量饮酒的范围应每日酒精量不超过40g.
目的 繫統評價源自于中、日、韓關于飲酒和卒中關繫的前瞻性隊列研究,探討東亞男性飲酒和卒中及全因死亡的關繫.方法 檢索Pubmed等數據庫,納入符閤入選條件的前瞻性隊列研究,記錄研究來源國傢、研究對象例數、性彆、年齡(均數或中位數及間距)、隨訪期限、飲酒量(g/d)、與飲酒相關的卒中或死亡相對風險(RR)及95%可信區間(CI)等.根據異質性檢驗結果,採用隨機或固定效應模型,以RR作為評價飲酒量與缺血性卒中或齣血性卒中髮病率及全因死亡率的風險效應指標.結果 共納入17項前瞻性隊列研究.樣本量最小1 322人,最大108 461人,9項研究報道瞭全因死亡;7項報道瞭缺血性卒中、7項報道瞭齣血性卒中.隨訪期間4.1～19.0年.分層比較顯示每日飲酒量≤20、21～40、41～60、＞60 g/d的各組與不飲酒者比較,缺血性卒中風險(RR及95%CI)分彆為0.85(0.78～0.93;P=0.0002)、0.94(0.79～1.11;P=0.46)、1.08(0.86～1.37;P=0.50)和1.24(0.96～1.59;P=0.10);齣血性卒中風險分彆為0.92(0.75～1.12;P=0.40)、1.11(0.96～1.28;P=0.17)、1.20(0.92～1.56;P=0.18)和1.74(1.32～2.28;P＜0.01);全因死亡風險分彆為0.83(0.75～0.91,P=0.01)、0.93(0.87～0.99,P=0.03)、1.01(0.95～1.07;P=0.86)和1.32(1.29～1.36;P＜0.01).結論 在東亞男性人群中,少量飲酒(≤20 g/d)降低缺血性卒中的風險,過量飲酒使卒中(尤其是齣血性卒中)、全因死亡的風險明顯增加.適量飲酒的範圍應每日酒精量不超過40g.
목적 계통평개원자우중、일、한관우음주화졸중관계적전첨성대렬연구,탐토동아남성음주화졸중급전인사망적관계.방법 검색Pubmed등수거고,납입부합입선조건적전첨성대렬연구,기록연구래원국가、연구대상례수、성별、년령(균수혹중위수급간거)、수방기한、음주량(g/d)、여음주상관적졸중혹사망상대풍험(RR)급95%가신구간(CI)등.근거이질성검험결과,채용수궤혹고정효응모형,이RR작위평개음주량여결혈성졸중혹출혈성졸중발병솔급전인사망솔적풍험효응지표.결과 공납입17항전첨성대렬연구.양본량최소1 322인,최대108 461인,9항연구보도료전인사망;7항보도료결혈성졸중、7항보도료출혈성졸중.수방기간4.1～19.0년.분층비교현시매일음주량≤20、21～40、41～60、＞60 g/d적각조여불음주자비교,결혈성졸중풍험(RR급95%CI)분별위0.85(0.78～0.93;P=0.0002)、0.94(0.79～1.11;P=0.46)、1.08(0.86～1.37;P=0.50)화1.24(0.96～1.59;P=0.10);출혈성졸중풍험분별위0.92(0.75～1.12;P=0.40)、1.11(0.96～1.28;P=0.17)、1.20(0.92～1.56;P=0.18)화1.74(1.32～2.28;P＜0.01);전인사망풍험분별위0.83(0.75～0.91,P=0.01)、0.93(0.87～0.99,P=0.03)、1.01(0.95～1.07;P=0.86)화1.32(1.29～1.36;P＜0.01).결론 재동아남성인군중,소량음주(≤20 g/d)강저결혈성졸중적풍험,과량음주사졸중(우기시출혈성졸중)、전인사망적풍험명현증가.괄량음주적범위응매일주정량불초과40g.
Objective To assess the dose-response relationship between alcohol intake and relative risk of stroke and all-cause mortality among Eastern Asian men. Methods Potential prospective cohort studies were retrieved by searching Pubmed ( 1966 - 2000 ), OVI D ( 1980 - 2009 ), Embase (1980-2009)and ISI Web of Knowledge (1986 -2009) using Medical Subject Headings: alcohol drinking, ethanol,stroke, cerebrovascular disease, mortality, etc; and Koreans or Japanese or Chinese. From the relevant retrieved reports, 17 prospective cohort studies fulfilling the criteria were included into the study.Information on study design, participant characteristics, amount of alcohol intake, stroke and/or all-cause mortality outcomes, control for potential confounding factors and risk estimates was abstracted by a standardized protocol. For each study, relative risk (RR) and 95% confidence interval (CI) were extracted and pooled with either a fixed or random effect model according to the results of the test of heterogeneity.Results As data available for women were too limited to be included into our meta-analysis, this study focused on male subjects, ranging from 1322 to 108 461 subjects among these 17 cohort studies. Compared with nondrinkers, the RRs of ischemic stroke for those drinking alcohol ≤20, 21 -40, 41 -60, >60 g/d,were0.85 (0.78-0.93, P=0.0002), 0.94 (0.79-1.11, P=0.46), 1.08 (0.86-1.37, P=0.50)and 1.24 (0. 96 - 1.59, P =0. 10) respectively. Similarly, RRs of hemorrhagic stroke were 0.92 (0.75 -1.12, P=0.46), 1.11 (0.96- 1.28, P =0. 17), 1.20 (0.92 - 1.56, P =0.18) and 1.74 (1.32 -2.28, P<0.01); and those of all-cause mortality were 0.83 (0.75 -0.91, P=0.01), 0.93(0.87-0.99, P=0.03), 1.01 (0.95-1.07, P=0.86) and 1.32 (1.29-1.36, P<0.01) respectively.Conclusion In Eastern Asian men, light alcohol intake ( ≤ 20 g/d) is associated with a lowered risk of ischemic stroke whereas heavy alcohol intake is associated with an elevated risk of stroke, particularly hemorrhagic stroke and all-cause mortality.
