合并肝脏疾病时的酒精摄入：多少算过量？
Alcohol Consumption in Concomitant Liver Disease: How Much is Too Much?
作者信息
Hagström Hannes
机构信息
Centre for Digestive Diseases, Division of Hepatology, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.
Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden.
出版信息
Curr Hepatol Rep. 2017;16(2):152-157. doi: 10.1007/s11901-017-0343-0. Epub 2017 Apr 22.
PURPOSE OF REVIEW
High consumption of alcohol can lead to cirrhosis. The risk of a low to moderate consumption of alcohol in the setting of a concurrent liver disease is less clear. The aim of this review is to sum the evidence on the risk of adverse outcomes in patients with liver diseases other than alcoholic liver disease who consume alcohol.
RECENT FINDINGS
High alcohol consumption is strongly associated with adverse outcomes in most liver diseases. For hepatitis C, some evidence points to an increased risk for fibrosis progression also with low amounts. For non-alcoholic fatty liver disease, most studies indicate an inverse association between fibrosis and alcohol consumption, but methodological limitations reduce inference.
SUMMARY
High alcohol consumption is associated with an increased risk of fibrosis progression and other adverse outcomes, while less is clear regarding low to moderate consumption. Obtaining high-level evidence on this topic ought to be the objective of future studies. Currently, an individual risk profile should be obtained in patients with liver disease who consume alcohol.
综述目的
高酒精摄入量可导致肝硬化。在合并肝脏疾病的情况下，低至中度酒精摄入量的风险尚不清楚。本综述的目的是总结关于非酒精性肝病患者饮酒导致不良后果风险的证据。
最新发现
在大多数肝脏疾病中，高酒精摄入量与不良后果密切相关。对于丙型肝炎，一些证据表明少量饮酒也会增加纤维化进展的风险。对于非酒精性脂肪性肝病，大多数研究表明纤维化与酒精摄入量呈负相关，但方法学上的局限性降低了推断的准确性。
总结
高酒精摄入量与纤维化进展及其他不良后果的风险增加有关，而低至中度酒精摄入量的情况尚不清楚。获得关于这一主题的高级别证据应该是未来研究的目标。目前，对于饮酒的肝病患者应进行个体风险评估。
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