Yoshida N, Hatori T, Ueno Y, Shibata M, Sadamoto T, Yamamuro W, Sumino Y, Nonaka H, Sugimoto M, Abei T
Second Department of Internal Medicine, Toho University School of Medicine.
Arukoru Kenkyuto Yakubutsu Ison. 1991 Dec;26(6):531-43.
In order to elucidate the mode of progression of alcoholic liver disease, relationships among the drinking style, laboratory data, anti-HCV antibody and histological changes were investigated on 36 patients in whom the liver biopsy was repeatedly done. Following results were obtained (1) In the group of continuous drinking over 100g ethanol per day, histological progression was found in 11 of 13 patients (85%) regardless of positive anti-HCV. On the other hand, in the group of abstinence or temperance less than 60g daily alcohol intake, histological improvement was found in 6 of 11 patients (55%). (2) Histological improvement was predominantly seen by abstinence or temperance in the cases with lower levels of serum IgA and adenosine deaminase (ADA) on hospitalization and those with rapid decrease in serum gamma-GTP after hospitalization. In conclusion, the amount of ethanol was considered to be the most important factor to affect on a progression of alcoholic liver diseases. Assessment of laboratory data such as IgA and ADA on hospitalization and change in gamma-GTP after hospitalization were also thought to be useful in foreseeing the prognosis of alcoholic liver disease.
为阐明酒精性肝病的进展方式,对36例反复进行肝活检的患者的饮酒方式、实验室数据、抗丙型肝炎病毒(HCV)抗体与组织学变化之间的关系进行了研究。获得了以下结果:(1)在每天饮酒超过100克乙醇的持续饮酒组中,13例患者中有11例(85%)出现了组织学进展,无论抗HCV是否阳性。另一方面,在戒酒或每日酒精摄入量低于60克的节制饮酒组中,11例患者中有6例(55%)出现了组织学改善。(2)在住院时血清IgA和腺苷脱氨酶(ADA)水平较低以及住院后血清γ-谷氨酰转肽酶(γ-GTP)迅速下降的病例中,戒酒或节制饮酒主要可见组织学改善。总之,乙醇量被认为是影响酒精性肝病进展的最重要因素。住院时对IgA和ADA等实验室数据的评估以及住院后γ-GTP的变化也被认为有助于预测酒精性肝病的预后。