Sato H, Takase S, Takada A
Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
J Hepatol. 1989 Mar;8(2):150-7. doi: 10.1016/0168-8278(89)90002-0.
Liver and spleen volumes were determined using computed tomography in 57 subjects with alcoholic liver disease and 76 subjects with nonalcoholic liver disease, in order to clarify the clinical characteristics and pathogenetic mechanisms of portal hypertension in alcoholic liver disease. The liver volumes in alcoholic liver disease were significantly larger than those in nonalcoholic liver disease, except in cases of decompensated liver cirrhosis. The increase in liver volume in alcoholic liver disease showed a significant correlation with the degree of hepatocytic ballooning. Overlapping of values for liver volume between alcoholic and nonalcoholic liver disease was quite small, suggesting that determination of liver volumes could be helpful for making etiological diagnoses in chronic liver disease. Spleen volumes were increased in the advanced cases of both alcoholic and nonalcoholic liver disease. The correlations between liver and spleen volumes were quite different between alcoholic and nonalcoholic liver disease. In nonalcoholic liver disease, a negative correlation was obtained, while, on the other hand, it was significantly positive in alcoholic liver disease. This appears to suggest that the pathogenetic mechanism of portal hypertension may differ between the diseases. After abstinence from alcohol, the decrease in liver and spleen volumes showed a statistically significant correlation, suggesting that ballooning of the hepatocytes may play a role in the augmentation of portal hypertension in alcoholic liver disease.
为了阐明酒精性肝病门静脉高压的临床特征和发病机制，对57例酒精性肝病患者和76例非酒精性肝病患者进行了计算机断层扫描以测定肝脏和脾脏体积。除失代偿期肝硬化病例外，酒精性肝病患者的肝脏体积显著大于非酒精性肝病患者。酒精性肝病患者肝脏体积的增加与肝细胞气球样变程度显著相关。酒精性肝病和非酒精性肝病的肝脏体积值重叠很小，这表明测定肝脏体积有助于慢性肝病的病因诊断。酒精性和非酒精性肝病晚期病例的脾脏体积均增大。酒精性肝病和非酒精性肝病肝脏与脾脏体积之间的相关性差异很大。在非酒精性肝病中，二者呈负相关，而在酒精性肝病中则呈显著正相关。这似乎表明这两种疾病门静脉高压的发病机制可能不同。戒酒之后，肝脏和脾脏体积的减小呈现出统计学上的显著相关性，这表明肝细胞气球样变可能在酒精性肝病门静脉高压的加重中起作用。
