Arnold W
Klinik für Innere Medizin II, Bremen.
Leber Magen Darm. 1989 Mar;19(2):59-66, 69.
This review article is mainly concerned with the incidence and pathogenesis of alcohol-induced liver diseases. Clinically the most relevant symptom is a hepatomegaly. During the course of the disease there is to state progression to alcoholic hepatitis with increasing jaundice. The laboratory values show different patterns; severe courses develop progression to a fulminant hepatitis. The diagnostic approach includes exact patient's medical history, clinical and laboratory investigations, followed by a step-wise diagnostic procedure including histology. Therapeutically the main approach is a diet, in case of malnutrition substitution of vitamins and only rarely the need of corticosteroids and/or anabolic steroids. Prognosis and long-term course of alcoholic-induced liver disease depend mainly on the severity of the disease and the consequent alcohol-free diet.
这篇综述文章主要关注酒精性肝病的发病率和发病机制。临床上最相关的症状是肝肿大。在疾病过程中,会逐渐发展为酒精性肝炎,并伴有黄疸加重。实验室检查结果呈现不同模式;严重的病程会发展为暴发性肝炎。诊断方法包括详细的患者病史、临床和实验室检查,随后是包括组织学检查在内的逐步诊断程序。治疗上主要方法是饮食调整,对于营养不良患者补充维生素,只有极少数情况下需要使用皮质类固醇和/或合成代谢类固醇。酒精性肝病的预后和长期病程主要取决于疾病的严重程度以及随之而来的戒酒饮食。