饮酒与脑出血关系的Meta分析

doi:10.3877/cma.j.issn.2095-9141.2019.05.008

目的

通过系统综述和Meta分析研究饮酒与脑出血的关系。

方法

运用系统评价的方法，在线检索Ovid、MEDLINE、EMBASE等英文数据库及CNKI、万方等中文数据库自建库至2019年5月收录的饮酒与脑出血发生风险相关的文献，并对文献进行质量评价和数据提取，采用RevMan5.3和Stata12.0软件进行Meta分析。

结果

研究共纳入文献10篇。Meta分析显示出饮酒与脑出血发生差异有统计学意义（OR=0.85，95%CI：0.73~0.98，P=0.02），少量到中等量饮酒与脑出血的发生差异有统计学意义（OR=0.69，95%CI：0.60~0.79，P<0.001），大量饮酒与脑出血的发生差异有统计学意义（OR=1.41，95%CI：1.06~1.89，P=0.02）；女性饮酒与脑出血的发生差异有统计学意义（OR=0.59，95%CI：0.48~0.72，P<0.001），男性饮酒与脑出血的发生差异无统计学意义（OR=0.10，95%CI：0.89~1.14，P=0.95）。高加索人群中饮酒是脑出血发生的保护性因素（OR=0.77，95%CI：0.61~0.97，P=0.03）。

结论

饮酒与脑出血发生具有相关性，大量饮酒能明显增加脑出血的发生率。

关键词: 饮酒, 脑出血, Meta分析

Objective

To study on the relationship between drinking and cerebral hemorrhage by systematic review and meta-analysis.

Methods

By using the method of systematic evaluation, online searches were conducted on English databases such as Ovid, MEDLINE, EMBASE and Chinese databases such as CNKI and Wanfang to retrieve the literature related to the risk of drinking and cerebral hemorrhage collected from the self-established database to May 2019. The quality of the literature was evaluated and the data were extracted. Meta-analysis was carried out using RevMan 5.3 and Stata12.0 software.

Results

The study included 10 articles in total. Meta-analysis showed statistically significant differences between drinking and cerebral hemorrhage (OR=0.85, 95%CI: 0.73-0.98, P=0.02). There were significant differences in the incidence of small to medium amount of alcohol drinking and cerebral hemorrhage (OR=0.69, 95%CI: 0.60-0.79, P<0.001). There was a statistically significant difference in the incidence of heavy drinking and cerebral hemorrhage (OR=1.41, 95%CI: 1.06-1.89, P=0.02). There was a statistically significant difference between female drinking and cerebral hemorrhage (OR=0.59, 95%CI: 0.48-0.72, P<0.001), there was no significant difference in male drinking and cerebral hemorrhage (OR=0.10, 95%CI: 0.89-1.14, P=0.95). In the Caucasian population, drinking is a protective factor in the occurrence of cerebral hemorrhage (OR=0.77, 95%CI: 0.61-0.97, P=0.03).

Conclusion

Drinking and cerebral hemorrhage have a correlation, a large number of alcohol drinking can significantly increase the incidence of cerebral hemorrhage.

Key words: Alcohol, Cerebral hemorrhage, Meta-analysis

表1 纳入文献的一般特征

作者	研究参与人数	国家	研究类型	出血组数量	NOS评分	随访年限
Nielsen等^[20](2005)	12096	美国	队列研究	94	7	16
Leppala等^[14](1999)	26556	芬兰	队列研究	156	6	6.1
Bazzano等^[16](2007)	64338	中国	队列研究	326	6	10
Ikehara等^[11](2013)	47100	日本	队列研究	709	7	19
Costa等^[13](2018)	6328	意大利	病例对照研究	3173	7	12
Rist等^[18](2010)	21860	美国	队列研究	156	7	21.6
Jones等^[17](2015)	12433	美国	队列研究	81	7	22.6
Jimenez等^[19](2012)	114928	美国	队列研究	439	7	4
Sankai等^[15](2000)	12372	日本	队列研究	71	7	9.4
Lu等^[12](2008)	45449	瑞典	队列研究	47	7	11

表1 纳入文献的一般特征

作者	研究参与人数	国家	研究类型	出血组数量	NOS评分	随访年限
Nielsen等^[20](2005)	12096	美国	队列研究	94	7	16
Leppala等^[14](1999)	26556	芬兰	队列研究	156	6	6.1
Bazzano等^[16](2007)	64338	中国	队列研究	326	6	10
Ikehara等^[11](2013)	47100	日本	队列研究	709	7	19
Costa等^[13](2018)	6328	意大利	病例对照研究	3173	7	12
Rist等^[18](2010)	21860	美国	队列研究	156	7	21.6
Jones等^[17](2015)	12433	美国	队列研究	81	7	22.6
Jimenez等^[19](2012)	114928	美国	队列研究	439	7	4
Sankai等^[15](2000)	12372	日本	队列研究	71	7	9.4
Lu等^[12](2008)	45449	瑞典	队列研究	47	7	11

图1 饮酒与脑出血的关系森林图

图2 饮酒量对脑出血发病率的影响

图3 不同性别饮酒对脑出血发病率的影响

表2 饮酒与脑出血发生关系的亚组研究

组别	饮酒人群（出血人数/未出血人数）	无饮酒人群（出血人数/未出血人数）	OR值	95%CI	P值
亚洲人群	672/396 886	1 964/1 031 683	0.96	0.88~1.05	0.38
高加索人群	1 089/320 497	738/128 135	0.77	0.61~0.97	0.03

表2 饮酒与脑出血发生关系的亚组研究

组别	饮酒人群（出血人数/未出血人数）	无饮酒人群（出血人数/未出血人数）	OR值	95%CI	P值
亚洲人群	672/396 886	1 964/1 031 683	0.96	0.88~1.05	0.38
高加索人群	1 089/320 497	738/128 135	0.77	0.61~0.97	0.03

图4 纳入文献风险偏倚的漏斗图

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Meta-analysis of the relationship between drinking and cerebral hemorrhage

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Meta-analysis of the relationship between drinking and cerebral hemorrhage