Spahr L, Hadengue A
Service de gastroentérologie et d'hépatologie Hôpitaux universitaires de Genève.
Rev Med Suisse. 2005 Sep 7;1(31):2032-4.
Both alcoholic and non-alcoholic steatohepatitis share common histological findings and the risk of developing cirrhosis. Liver biopsy is required for the diagnosis, and the aim of treatment is to prevent cirrhosis. In alcoholic steatohepatitis, abstinence from alcohol is associated to prednisone in a severe form, as defined by a Maddrey's score > 32. Due to common pathogenic mechanisms, we recommend that coexisting metabolic alterations that are commonly observed in non-alcoholic steatohepatitis should also be treated in alcoholics. Thus, weight reduction, physical exercise, improvement of insulin sensitivity and reduction of oxidative stress, all may be beneficial both in alcoholic and non-alcoholic steatohepatitis.
酒精性和非酒精性脂肪性肝炎具有共同的组织学特征以及发展为肝硬化的风险。诊断需要进行肝活检，治疗的目的是预防肝硬化。在酒精性脂肪性肝炎中，对于马德雷评分>32所定义的严重形式，戒酒与使用泼尼松相关。由于致病机制相同，我们建议，在酒精性肝病患者中，对于非酒精性脂肪性肝炎中常见的并存代谢改变也应进行治疗。因此，减轻体重、体育锻炼、改善胰岛素敏感性以及减轻氧化应激，所有这些对酒精性和非酒精性脂肪性肝炎可能都有益处。
