Abittan CS, Lieber CS
Mount Sinai Medical Center, 1 Gustave L. Levey Place, New York, NY 10029.
Curr Treat Options Gastroenterol. 1999 Feb;2(1):72-80. doi: 10.1007/s11938-999-0022-5.
The traditional approach to alcoholism is treatment of underlying psychological and behavioral problems. Earlier and more direct avenues to prevent or counteract alcohol's effects include a focus on early detection of alcoholism, using, in part, biochemical markers of heavy drinking such as carbohydrate-deficient transferrin (CDT) and screening, among heavy users of alcohol, for signs of medical complications. Only a few heavy drinkers eventually develop liver cirrhosis. Because no practical genetic markers exist indicating who will develop fibrosis and cirrhosis, heavy drinkers who have signs of liver injury should undergo liver biopsy to determine whether they have perivenular fibrosis, a recognized precursor lesion to cirrhosis. Those who do should start intense treatment efforts, such as correction of nutritional deficits, curbing alcohol consumption, and participation in ongoing controlled trials. Some "supernutrients" have been effective in baboons, including S-adenosylmethionine for the treatment of alcohol-induced liver injury and polyenylphosphatidylcholine for the prevention of fibrosis. Both drugs are now being tested in humans. Prednisolone improves survival in patients with alcoholic hepatitis who have either spontaneous hepatic encephalopathy or a high "discriminant function."
传统的酒精中毒治疗方法是针对潜在的心理和行为问题进行治疗。预防或对抗酒精影响的更早期、更直接的途径包括，部分通过关注酒精中毒的早期检测，利用重度饮酒的生化标志物，如缺糖转铁蛋白（CDT），并在重度饮酒者中筛查医学并发症的迹象。只有少数重度饮酒者最终会发展为肝硬化。由于不存在表明谁会发展为肝纤维化和肝硬化的实用基因标志物，有肝损伤迹象的重度饮酒者应接受肝活检，以确定他们是否患有静脉周围纤维化，这是一种公认的肝硬化前期病变。确诊者应开始积极的治疗措施，如纠正营养缺乏、控制酒精摄入，并参与正在进行的对照试验。一些“超级营养素”在狒狒身上已显示出效果，包括用于治疗酒精性肝损伤的S-腺苷甲硫氨酸和用于预防纤维化的多烯磷脂酰胆碱。这两种药物目前都在人体中进行试验。泼尼松龙可提高患有自发性肝性脑病或高“判别功能”的酒精性肝炎患者的生存率。
