Shetty Shiran, Venkatakrishnan L, Krishanveni J, Kumari Shantha
Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal University, Manipal, 576 104, India.
Department of Gastrenterology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India.
Indian J Gastroenterol. 2017 Jan;36(1):23-26. doi: 10.1007/s12664-016-0720-6. Epub 2017 Jan 3.
Alcoholic hepatitis and cirrhosis although part of spectrum of alcoholic liver disease can have overlapping features, and differentiating them using clinical, biochemical, and imaging features is not always possible. Standard therapy for each differs, and steroid therapy while beneficial in alcoholic hepatitis may be detrimental in cirrhosis due to high infectious complications. We analyzed our experience with liver biopsy in patients with severe alcoholic hepatitis.
Male patients in the age group of 25-65 years who were clinically diagnosed with severe alcoholic hepatitis (DF > 32) were retrospectively analyzed and included in this study. All of them had undergone transjugular liver biopsy within the first 7 days of hospitalization.
Thirty patients were included. Most were in the 35-55 age group. Jaundice was present in all patients with fever and tender hepatomegaly also being common. On histopathological evaluation, 33.3% (n = 10) suspected clinically to have alcoholic hepatitis had underlying cirrhosis.
Cirrhosis is found in one third of patients with severe alcoholic hepatitis. This may alter our approach to management of this condition.
酒精性肝炎和肝硬化虽属酒精性肝病范畴，但可能有重叠特征，利用临床、生化和影像学特征进行鉴别并不总是可行。二者的标准治疗方法不同，类固醇疗法对酒精性肝炎有益，但对肝硬化可能有害，因为会导致高感染并发症。我们分析了严重酒精性肝炎患者肝活检的经验。
对年龄在25 - 65岁、临床诊断为严重酒精性肝炎（判别函数>32）的男性患者进行回顾性分析并纳入本研究。所有患者均在住院的前7天内接受了经颈静脉肝活检。
纳入30例患者。大多数在35 - 55岁年龄组。所有患者均有黄疸，发热和肝肿大压痛也很常见。组织病理学评估显示，临床怀疑为酒精性肝炎的患者中有33.3%（n = 10）存在潜在肝硬化。
三分之一的严重酒精性肝炎患者存在肝硬化。这可能会改变我们对这种疾病的治疗方法。
