Miyashima Yuichi, Shibata Michihiko, Honma Yuichi, Matsuoka Hidehiko, Hiura Masaaki, Abe Shintaro, Harada Masaru
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Intern Med. 2017 Dec 15;56(24):3293-3297. doi: 10.2169/internalmedicine.8767-16. Epub 2017 Oct 11.
A 49-year-old woman with a history of heavy alcohol drinking was admitted to our hospital due to jaundice and abdominal distention. A blood test showed leukophilia, mild hypoalbuminemia, hyperbilirubinemia, hepatobiliary injury and coagulopathy. Image studies showed an extremely enlarged fatty liver and splenomegaly. The Japan alcoholic hepatitis score and Maddrey's discriminant function were 10 and 54 points, respectively. We diagnosed her with severe alcoholic hepatitis and treated her with corticosteroids, but her liver function did not improve. We therefore administered the vitamin E product tochopheryl acetate (150 mg/day) as an add-on therapy, after which her leukophilia, liver enzymes and coagulopathy improved immediately.
一名有大量饮酒史的49岁女性因黄疸和腹胀入住我院。血液检查显示白细胞增多、轻度低白蛋白血症、高胆红素血症、肝胆损伤和凝血功能障碍。影像学检查显示脂肪肝极度肿大和脾肿大。日本酒精性肝炎评分和马德雷判别函数分别为10分和54分。我们诊断她为重度酒精性肝炎，并用皮质类固醇进行治疗，但她的肝功能没有改善。因此，我们加用维生素E产品醋酸生育酚（150毫克/天）进行治疗，之后她的白细胞增多、肝酶和凝血功能障碍立即得到改善。
