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酒精摄入会使慢性丙型肝炎患者更容易出现界面性肝炎。

Alcoholic intake predisposes to more interface hepatitis in chronic hepatitis C.

作者信息

Gomes de Sá Ribeiro María de Fátima, da Costa Gayotto Luiz Carlos, de Alencar Fischer Chamone Dalton, Strauss Edna

机构信息

Gastroenterology Clinic, Heliopolis Hospital.

出版信息

Ann Hepatol. 2005 Jul-Sep;4(3):176-83.

Abstract

Progression of liver disease in chronic hepatitis C depends on several factors related to the host, virus and the environment which deserves further investigations. 120 candidates for blood donation with hepatitis C virus were divided into three groups according to alcohol intake: abstainers, light drinkers and heavy drinkers. Liver histopathology alterations, namely architectural staging, periportal and lobular inflammation as well as portal inflammatory infiltrate were graded from 0 to 4 and afterwards divided into light (0 to 2) and severe (3 to 4). There were more drinkers among men (83.5%) than among women (41.5%). Regarding the three groups, mild periportal inflammation was significantly related with abstainers and light drinkers groups whereas severe periportal inflammation was more predominant in heavy drinkers (p = 0.033). When we compared mild with severe histopathological alterations older age was significantly (p = 0.004) associated with severe fibrosis, periportal inflammation and portal inflammatory infiltrate. In relation to enzyme levels a significant difference in fibrosis and lobular activity was found for ALT, AST and GGT. Only AST was a marker of greater portal inflammatory infiltrate. Additionally, platelets were significantly lower in severe fibrosis and in periportal inflammation. Logistic regression analysis identified AST and platelets as independent predictors for severe fibrosis. In conclusion, a correlation was found between alcohol consumption and periportal inflammation. Fibrosis correlated with age, high enzymes levels and low platelets. AST and platelets were the best predictors for severe fibrosis.

摘要

慢性丙型肝炎患者肝病的进展取决于与宿主、病毒及环境相关的多种因素,值得进一步研究。120名丙型肝炎病毒献血候选者根据饮酒量被分为三组:戒酒者、轻度饮酒者和重度饮酒者。肝组织病理学改变,即结构分期、汇管区和小叶炎症以及门静脉炎性浸润,从0到4分级,然后分为轻度(0至2)和重度(3至4)。男性饮酒者(83.5%)多于女性饮酒者(41.5%)。在这三组中,轻度汇管区炎症与戒酒者和轻度饮酒者组显著相关,而重度汇管区炎症在重度饮酒者中更为常见(p = 0.033)。当我们比较轻度与重度组织病理学改变时,年龄较大与重度纤维化、汇管区炎症和门静脉炎性浸润显著相关(p = 0.004)。关于酶水平,在ALT、AST和GGT方面,纤维化和小叶活性存在显著差异。只有AST是门静脉炎性浸润更严重的标志物。此外,重度纤维化和汇管区炎症患者的血小板显著降低。逻辑回归分析确定AST和血小板是重度纤维化的独立预测指标。总之,发现饮酒与汇管区炎症之间存在相关性。纤维化与年龄、高酶水平和低血小板相关。AST和血小板是重度纤维化的最佳预测指标。

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