Paukov V S, Ermakova O M, Kostornaia I V
Arkh Patol. 2008 Sep-Oct;70(5):25-9.
Liver biopsy specimens were morphologically investigated in 87 patients, including 30 with drug (marijuana and poppy straw) addiction, 23 with chronic alcoholic intoxication, and 25 abused narcotics and alcohol concomitantly. All the patients were not found to be infected with viruses of hepatitis B, C, G, TTV, or CMN; the clinical manifestations and biochemical blood parameters were studied over time. In patients who simultaneously used drugs and alcohol, the specific features of hepathopathy were shown to be more pronounced and more rapidly progressive changes as fatty hepatosis and diffuse liver tissue fibrosis than in those used either drugs alone or alcohol alone. This is favored by chronic inflammation and cholestasis that is accompanied by bile duct proliferation. Concomitance of these processes leads to permanent liver tissue atrophy and death and to the relatively early development of hepatic monolobular cirrhosis. The mechanisms responsible for the patho- and morphogenesis of combined toxic hepatopathy are discussed.
对87例患者的肝活检标本进行了形态学研究，其中包括30例药物（大麻和罂粟秆）成瘾者、23例慢性酒精中毒者以及25例同时滥用麻醉品和酒精者。所有患者均未检测出感染乙型、丙型、G型、TTV或CMN肝炎病毒；对其临床表现和血液生化参数进行了长期研究。结果显示，与单独使用药物或酒精的患者相比，同时使用药物和酒精的患者肝病的特定特征更为明显，脂肪性肝病和弥漫性肝组织纤维化等变化进展更快。慢性炎症和胆汁淤积伴胆管增生有利于这种情况的发生。这些过程同时出现会导致肝组织永久性萎缩和死亡，并导致肝单小叶肝硬化相对较早地发展。文中讨论了合并中毒性肝病的病理和形态发生机制。
