Takase S, Takada N, Enomoto N, Yasuhara M, Takada A
Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
Hepatology. 1991 May;13(5):876-81.
To verify the existence of chronic hepatitis induced by alcohol, the clinicopathological features of chronic hepatitis in heavy drinkers were studied using various viral markers. Histological features of chronic active hepatitis were seen in 27 heavy drinkers. These patients were divided into four groups. The AL group (seven cases) consisted of alcoholics who were negative for both hepatitis C antibody and HBsAg; the HB group (four cases) was positive for HBsAg; the HC1 group (seven cases) was positive for hepatitis C antibody but negative for hepatitis C virus-RNA genome; and the HC2 group (nine cases) was positive both for hepatitis C antibody and hepatitis C virus-RNA genome. Serum AST and ALT activity declined during 4 wk of abstinence in most patients in the AL group and in the HC1 group. The response of serum AST and ALT to abstinence was poor in most patients in the HB group and the HC2 group. Serum desialo-transferrin and alcohol liver membrane antibodies were detected more frequently in the sera of patients in the AL group and HC1 group. A trend toward increased frequency of centrilobular ballooning existed in the AL group, but this did not reach statistical significance. These results suggest that chronic active hepatitis in patients in the AL group, in whom markers of HBV and hepatitis C virus were absent, may be caused by alcohol. Patients in the HC1 group who had hepatitis C antibody but not hepatitis C virus-RNA may represent cases where both alcohol and hepatitis C virus are involved.
为证实酒精所致慢性肝炎的存在，利用多种病毒标志物对重度饮酒者慢性肝炎的临床病理特征进行了研究。在27例重度饮酒者中观察到慢性活动性肝炎的组织学特征。这些患者被分为四组。酒精性肝病组（AL组，7例）由丙型肝炎抗体和HBsAg均为阴性的酗酒者组成；HBsAg阳性组（HB组，4例）；丙型肝炎抗体阳性但丙型肝炎病毒RNA基因组阴性组（HC1组，7例）；丙型肝炎抗体和丙型肝炎病毒RNA基因组均阳性组（HC2组，9例）。在戒酒4周期间，AL组和HC1组的大多数患者血清AST和ALT活性下降。HB组和HC2组的大多数患者血清AST和ALT对戒酒的反应较差。在AL组和HC1组患者血清中更频繁地检测到血清去唾液酸转铁蛋白和酒精肝膜抗体。AL组存在中央小叶气球样变频率增加的趋势，但未达到统计学意义。这些结果表明，AL组中缺乏HBV和丙型肝炎病毒标志物的患者的慢性活动性肝炎可能由酒精引起。HC1组中具有丙型肝炎抗体但无丙型肝炎病毒RNA的患者可能代表酒精和丙型肝炎病毒均参与的病例。
