酒精性肝病的危险因素分析  

Analysis of risk factors for alcoholic liver diseases

作　　者：鲁晓岚[1] 罗金燕[1] 陶明[1] 赵平[1] 赵红利[1] 张晓东[1] 耿燕[1] 

机构地区：[1]西安交通大学第二医院,西安710004

出　　处：《胃肠病学和肝病学杂志》2004年第2期172-174,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：卫生部科研基金资助课题 (98 1 2 36)

摘　　要：目的　明确ALD患病率与酒精摄入的量、饮酒的方式习惯、种类及肥胖等的关系。方法　对西安城乡 4115名各种不同职业人群进行整群随机抽样调查及流行病学资料分析。每一调查对象均经调查员上门按统一要求详细询问其饮酒的种类、品牌、度数、时间、频度、方式及饮酒后不良事件的发生次数等 ,必要时还询问其家人 ,以便能更准确的估计其酒精摄入的量。所有饮酒人群均经B超检查 ,并抽取外周血查肝功 ,HBsAg、抗HCV。结果　①每日饮酒精≥ 40g ,持续饮用 5年以上 ,ALD患病率明显增加 ,最高的OR值出现在日酒精消耗量≥ 160g时 ,此时ALD患病率高达 18 7%。而每日饮酒精 <2 0g ,饮酒时间 <5年时 ,无ALD发生。②空腹饮酒者各种酒类的日均消耗量均大于只在进餐时饮酒者 ,空腹单纯饮用白酒和多种酒混合饮用患病率最高 ,分别达18 9%和 15 4%。单纯饮用啤酒等有色酒者ALD发生率较低。③BMI≥ 2 5的 2 0 3例日均酒精消耗量低于BMI <2 5的人群 ,患病率11 5 % ,明显高于人群患病率 6 5 %。结论　日均酒精消耗量 <2 0g ,短于 5年是发生ALD的相对安全域值。日均酒精消耗量 >40g ,>5年则ALD的发病率明显增加 ;空腹饮用白酒和混合饮用多种酒类 ,ALD患病率较高。肥胖者饮酒 。Objective The purpose of the study was to examine the relationship of daily alcohlic beverage consumed,drinking patterns,and obesity to the alcoholic liver diseases.Methods By random cluster sampling ways take samples in every kind of and different occupation crowds and both city and rural people of Xian city,fully detected by specialist and detaily inquired:(a) medical history and family history.(b)evaluation of alcohol intake, type of alcoholic beverage consumed,drinking patterns by detailed dietary questionnaire.(c)routine blood tests and ultrasonography.Results Multivariate analysis showed that:(a)the risk threshold for developing alcoholic liver diseases was ingestion of more than 40g alcohol per day,keep on drinking for 5 years in male.The tallest OR appeared when the day alcohol consume≥160g,the rate is 18.7%.There were no ALD patients when ingestion of alcohol was less than 20g per day.(b)87.9% of all drank only at mealtimes.The cumulative risk of developing ALD was significantly higher for those individuals who regularly drank alcohol both with and without food than those who drank only at mealtimes,especially for those individuals who regularly drank hard liquors only and with multiple drinks.(c)The alcohol consume in those whose BMI≥25 was lower than those whose BMI <25,the risk increased to 11.5%,obviously higher than the crowd rate 6.5%.Conclusion Our data show that in an open population the risk threshold for developing ALD is 40g ethanol/day,and this risk increases with daily intake.Drinking alcohol outside mealtimes and drinking hard liquors only and with multiple different alcohol beverages both increase the risk of developing alcoholic liver diseases.Drinking 20g ethanol/day and less than 5 years are safe for ALD. Obesity can also increase the risk.

关 键 词：酒精性肝病 危险因素 肥胖 饮酒 流行病学 

分 类 号：R575[医药卫生—消化系统]