吸烟、饮酒和吸烟饮酒协同作用对脑血流动力学的影响

目的比较吸烟、饮酒和吸烟饮酒协同作用对脑血流动力学的影响。方法采用经颅多普勒检测技术对吸烟组(每天吸烟量﹥10支),饮酒组(经常饮白酒或有色酒每天﹥100g或啤酒每天﹥1L),吸烟、饮酒混合组(达到以上两种标准)的3组473例病人的脑血流动力学进行观察和比较,并对吸烟、饮酒和吸烟饮酒混合组在3个年龄组(青年组、中年组、老年组)的脑血流动力学的改变进行比较。结果脑血管狭窄或闭塞以吸烟饮酒混合组最明显共61例、吸烟组次之34例、饮酒组相对较低共17例(χ2=26.38,P﹤0.05)。引起血流减慢原因也是吸烟饮酒混合组最突出(χ2=9.34,P﹤0.05),而单吸烟组和单饮酒组之间无明显差异。在青年组和中年组中导致血流减慢的主要因素是烟酒混合组(χ2=9.6,P﹤0.01,χ2=8.7,P﹤0.05);老年组中导致血流减慢吸烟、饮酒和混合组三者之间差异无统计学意义(χ2=4.77,P﹥0.05)。在青年组中导致血管狭窄或闭塞吸烟、饮酒和混合组三者之间无明显差异(χ2=4.27,P﹥0.05),但在中、老年组中导致血管狭窄或闭塞以吸烟饮酒混合组明显(χ2=12.30,P﹤0.05、χ2=8.76,P﹤0.05),吸烟和饮酒组之间无明显差异。结论吸烟比饮酒更易导致脑血管狭窄或闭塞,而吸烟饮酒对脑血管狭窄或闭塞的形成有协同作用,并促使脑血流减慢随着年龄的增加向脑血管狭窄或闭塞转化。

Study on the Effects of smoking and drinking on cerebral hemodynamics

OBJECTIVE To observe the effects of smoking and drinking or both on cerebral hemodynamics. METHODS 473 patients were included in this study and were divided into smoking group, drinking group, and mixed group based on their smoking and drinking history. Meanwhile, these patients were also subdivided into three age-related groups ( young-aged group, middle-aged group, old-aged group). Cerebral hemodynamics parameters in these patients detected by using transcranial Doppler were analyzed. RESULTS 61 patients were detected by cerebral arterial stenosis or occlusion in mixed group, while 17 patients in smoking group and 34 patients in drinking group (χ2 = 26.38, P ﹤ 0.05). Slow blood flow is the most prominent characteristics for blood mixed group (χ2 = 9.37, P﹤0.05). The single-smoking and alcohol consumption alone did not show significant difference between groups. In young-and middle-aged groups, more patients with decreased blood flow velocity had a habit of both smoking and drinking (χ2 = 9.6, P﹤0.01, χ2 = 8.7, P﹤0.05). In the older group, there was no significant difference among smoking, drinking and mixed groups in slow blood flow (χ2 = 4.77, P﹥ 0.05). In young-aged group, there was no significant difference among patients with cerebral arterial stenosis or occlusion from smoking group, drink- ing group and mixed group (χ2 = 4.27, P﹥0.05). In middle- and old-aged group, more patients with cerebral arterial stenosis came from mixed group (χ2 = 12.30, P﹤0.05), while there was no significant difference between smoking group and drinking group (χ2 = 8.76, P﹤0.05). CONCLUSION Smoking is more easy to induce the formation of cerebral arterial stenosis or occlusion than drinking, while there is a synergistic effect of smoking and drinking exists on cerebral arterial stenosis or occlusion. Both the risk factors could accelerate the transformation from decreased blood flow velocity to cerebral arterial stenosis or occlusion.