Vŭrbanov G
Vutr Boles. 1989;28(6):36-40.
The study includes 108 patients with acute alcohol hepatitis, 45 patients with cholestasis and 124 healthy controls. In 14 patients (13%) cholestatic acute alcohol hepatitis was found. The patients with cholestatic acute alcohol hepatitis consumed considerably more alcohol than the other patients with acute alcohol hepatitis. The intensive jaundice led half of the patients with cholestatic acute alcohol hepatitis to the infectious diseases clinic and 32% of them to the surgical clinic. The course of the disease was heavy, with disturbed general condition, high temperature, pain in the right subcostal region but without itching. The patients showed higher levels of timol test, cholesterol, LDL-cholesterol, coefficient LDL/HDL-cholesterol, beta-lipoproteins, total lipids, gamma-GTP, ASAT and lower levels of leucocytes, bilirubin, SMC, alkaline phosphatase and LAP than the other patients with cholestasis. The patients with cholestatic acute alcohol hepatitis showed a higher level of total lipids and gamma-GTP than the other patients examined. The confirmation of the diagnosis implies the application of contemporary instrumental and invasive methods. The ultrasound examination is of special importance.
该研究纳入了108例急性酒精性肝炎患者、45例胆汁淤积患者和124名健康对照者。在14例患者（13%）中发现了胆汁淤积性急性酒精性肝炎。胆汁淤积性急性酒精性肝炎患者比其他急性酒精性肝炎患者饮酒量明显更多。严重黄疸致使一半的胆汁淤积性急性酒精性肝炎患者前往传染病科就诊，32%的患者前往外科就诊。疾病进程严重，全身状况不佳、体温升高、右季肋区疼痛，但无瘙痒。与其他胆汁淤积患者相比，这些患者的噻吗洛尔试验、胆固醇、低密度脂蛋白胆固醇、低密度脂蛋白/高密度脂蛋白胆固醇系数、β-脂蛋白、总脂质、γ-谷氨酰转肽酶、谷草转氨酶水平较高，而白细胞、胆红素、平滑肌肌动蛋白、碱性磷酸酶和亮氨酸氨肽酶水平较低。胆汁淤积性急性酒精性肝炎患者的总脂质和γ-谷氨酰转肽酶水平高于其他接受检查的患者。诊断的确立意味着要应用当代的仪器检查和侵入性方法。超声检查尤为重要。
