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饮酒对于不同血压的人群产生心房间传导阻滞风险的影响
引用本文:石晓美,孙国哲.饮酒对于不同血压的人群产生心房间传导阻滞风险的影响[J].心脏杂志,2022,34(5):521-526.
作者姓名:石晓美  孙国哲
作者单位:1.第一临床学院心血管内科 中国医科大学
摘    要: 目的 探讨饮酒对于不同血压的人群产生心房间传导阻滞(intra-atrial block, IAB)风险的影响,为不同血压的人群饮酒导致IAB提供有力防治依据。 方法 为了评估酒精摄入与不同血压人群产生IAB风险,将11 271名35岁以上的中国东北农村心脑血管健康常驻居民为研究对象,根据是否发生IAB(P波宽度≥0.12 s)为依据分为非IAB组(n=10 559)和IAB组(n=712)。分层研究中分为4组:不饮酒正常血压组(n=4 321)、不饮酒高血压组(n=4 178)、饮酒正常血压组(n=1 201)、饮酒高血压组(n=1 571)。对人群进行基线特征分析、分层分析以及多因素Logistic回归分析。 结果 在校正了混杂因素后,与非高血压人群比较,高血压合并饮酒患者的IAB患病率显著增高,OR值(95%可信区间)是1.47(1.04~2.07),且有统计学意义(P<0.01 ),在正常血压人群中,饮酒与否不是影响IAB患病率的重要影响因素,而在高血压人群中饮酒与否是IAB产生的重要影响因素,无论在饮酒人群,还是非饮酒人群,高血压均是影响IAB产生的重要危险因素。在IAB患者中,2、3级血压产生IAB的风险远高于正常血压人群和1级高血压人群。饮酒2级高血压(160/100≤BP<180/110 mmHg)组,OR(95%CI)是1.64(1.08~2.50);饮酒3级高血压(BP≥180/110 mmHg)组,OR(95%CI)为1.73(1.03~2.89),均有统计学意义。而在饮酒1级高血压(140/90≤BP<160/100 mmHg)组,OR(95%CI)是 1.32(0.90~1.92),心房间传导阻滞产生与血压无明显相关,在非饮酒人群中血压饮酒无明显相关。 结论 饮酒对于不同血压人群产生心房间传导阻滞风险的影响有明显差异。

关 键 词:P波宽度    心房间传导阻滞    血压    饮酒
收稿时间:2021-11-10

Effect of alcohol consumption on the risk of atrial block in people with different blood pressure
Affiliation:1.Department of Cardiovascology, First Clinical College2.Department of Cardiovascology, First Hospital, China Medical University, Shenyang 110001, Liaoning, China
Abstract: AIM To explore the effect of drinking on the risk of intra atrial block (IAB) in people with different blood pressure, so as to provide a strong basis for the prevention and treatment of IAB caused by drinking in people with different blood pressure. METHODS In order to assess the risk of IAB in people with different blood pressure and alcohol intake, 11271 permanent residents of the rural cardiovascular and cerebrovascular health research cohort in Northeast China over the age of 35 were divided into non IAB group (n=10559) and IAB group (n=712) according to whether IAB occurred (P wave width ≥0.12 s). The stratified study was divided into four groups: non drinking normal blood pressure group (n=4321), non drinking hypertension group (n=4178), drinking normal blood pressure group (n=1201) and drinking hypertension group (n=1571). Baseline structure analysis, stratified analysis and multivariate logistic regression analysis were carried out. RESULTS After adjusting for confounding factors, the prevalence of IAB in patients with hypertension combined with drinking was significantly higher than that in non hypertensive population. OR value was 1.47 ,the 95% confidence interval was (1.04~2.07) , which was statistically significant (P<0.01). In normal blood pressure population, drinking or not was not an important factor affecting the prevalence of IAB, Drinking or not is an important influencing factor of IAB in hypertensive population. Hypertension is an important risk factor of IAB, whether in drinking population or non drinking population.In patients with IAB, the risk of IAB caused by grade II and III blood pressure is much higher than that of normal blood pressure and grade I hypertension. For the drinking grade II blood pressure group (160/100mmHg≤BP<180/110 mmHg) , OR(95% CI) was 1.64 (1.08~2.50); for drinking grade III blood pressure group (BP≥180/110 mmHg) ,OR(95% CI) was 1.73 (1.03~2.89), both of which were statistically significant. In the grade I hypertension (140/90mmHg ≤ BP < 160/100 mmHg) in patients with drinking , OR(95% CI) was 1.32 (0.90~1.92), intra atrial block has no obvious correlation with blood pressure, and there was no significant correlation between blood pressure and alcohol consumption in non-drinkers. CONCLUSION The effect of alcohol consumption on the risk of intra atrial block (IAB) was significantly different in different blood pressure groups
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