戒酒可防房颤复发!澳大利亚随机对照研究:还可减体重和降血压

2020-01-06 朱朱 中国循环杂志

已有研究证实,过量饮酒与房颤发生和心房不良重构密切相关。《新英格兰医学杂志》发表的一项来自澳大利亚的多中心、前瞻性、开放标签、随机、对照研究提示,对于经常饮酒的房颤患者来说,戒酒可以减少房颤发作。研究者指出,经常饮酒是房颤的一个潜在可控危险因素,戒酒可以减轻房颤负荷和减少房颤复发。戒酒减轻房颤负荷的机制可能是多方面的,与改善自主神经调节功能、减轻心脏炎症、改善心房重构等有关。另外,每克酒精含有7

已有研究证实,过量饮酒与房颤发生和心房不良重构密切相关。

《新英格兰医学杂志》发表的一项来自澳大利亚的多中心、前瞻性、开放标签、随机、对照研究提示,对于经常饮酒的房颤患者来说,戒酒可以减少房颤发作。

研究者指出,经常饮酒是房颤的一个潜在可控危险因素,戒酒可以减轻房颤负荷和减少房颤复发。

戒酒减轻房颤负荷的机制可能是多方面的,与改善自主神经调节功能、减轻心脏炎症、改善心房重构等有关。

另外,每克酒精含有7 kcal热量,过量饮酒可能会导致体重增加以及心外膜脂肪增加,而后者有致心律失常的特性。

在该研究中,戒酒组患者在没有其他额外干预措施的前提下,戒酒后体重有所减轻。

酒精还可导致高血压。该研究中尽管许多患者血压数据缺失,但与一项针对36项临床试验的系统综述一致的是,戒酒组患者戒酒后血压有所降低,尤其是每周饮酒超过14杯的患者。

述评专家指出,该研究存在样本量小、基线饮酒量大(中重度)、房颤总负荷较轻(<2%)、随访时间较短等局限性。而且,要清醒认识到的一个事实是,对于很多房颤患者来说,彻底戒酒可能是一个很难达到的目标。

这项研究从澳大利亚6家医院纳入140例基线为窦性心律的阵发性或持续性房颤成年患者。这些患者每周至少喝10杯酒(1杯酒大约含12 g纯酒精),随机分入戒酒组和对照组(继续饮酒)。

戒酒组患者的平均饮酒量从每周16.8杯减少至2.1杯,对照组的平均饮酒量也从每周16.4杯减至13.2杯。

经历两周空白期后,戒酒组中房颤发生率为53%,对照组则有73%的患者出现房颤发作。

与对照组相比,戒酒组从入组至房颤复发的时间明显延长(HR=0.55)。

随访6个月时,戒酒组患者的房颤负荷显着低于对照组,两组中房颤持续时间占比平均分别为0.5%和1.2%。

来源:

1、Alcohol Abstinence in Drinkers with Atrial Fibrillation. N Engl J Med, 2020, 382: 20-28.

2、Anne M. Gillis. A Sober Reality? Alcohol, Abstinence, and Atrial Fibrillation. N Engl J Med, 2020, 382: 83-84.

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    2020-09-09 12177770m58暂无昵称

    学习了

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    2020-07-28 amyloid
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    2020-01-07 心介

    房颤,临床上碰到很多哦

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2038279, encodeId=a05f20382e938, content=<a href='/topic/show?id=167c984525d' target=_blank style='color:#2F92EE;'>#随机对照研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98452, encryptionId=167c984525d, topicName=随机对照研究)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLIQxicGuURvblbKDmmdLreAdrFKYA57y7viabog6mfk8dXQpQzYCf0ibcgoMnFrQ2MiaV8Iic4ocdhEfw/132, createdBy=0e3a2500177, createdName=ms1692810954239974, createdTime=Sun Jun 07 06:28:00 CST 2020, time=2020-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=884028, encodeId=d3b088402832, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Wed Sep 09 23:15:23 CST 2020, time=2020-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775491, encodeId=8d321e75491b8, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Tue Jul 28 23:28:00 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483977, encodeId=89a114839e786, content=<a href='/topic/show?id=66a666e3784' target=_blank style='color:#2F92EE;'>#澳大利亚#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66737, encryptionId=66a666e3784, topicName=澳大利亚)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=33da7929339, createdName=12498cbcm02(暂无昵称), createdTime=Wed Jan 08 14:28:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031210, encodeId=4346103121062, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Tue Jan 07 02:28:00 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038904, encodeId=d0f910389047b, content=高质量研究,读起来真爽,谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Tue Jan 07 02:28:00 CST 2020, time=2020-01-07, status=1, ipAttribution=)]
    2020-01-07 肿瘤克星

    高质量研究,读起来真爽,谢谢梅斯

    0

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