Unit of Addiction and Hepatology ASL3 Liguria, San Martino Hospital, Genova, Italy.
Unit of Addiction Treatment, Lugo, Ravenna, Italy.
Dig Liver Dis. 2020 Jan;52(1):21-32. doi: 10.1016/j.dld.2019.09.017. Epub 2019 Nov 19.
Worldwide, the prevalence of alcohol use disorder (AUD) is 20-30% in men and 10-15% in women, and cirrhosis due to alcohol-related liver disease (ALD) is responsible for 0.9% of global deaths and 47.9% of cirrhosis-related deaths. End-stage ALD (ESALD) is the final condition of alcohol-related cirrhosis, and severe acute alcohol-related hepatitis (SAAH) is a distinct clinical syndrome associated with the consumption of large amounts of alcohol. In some cases, ESALD, and SAAH may need liver transplantation (LT). Thus, the management of ESALD and SAAH in patients affected by AUD may be an essential part of the clinical skills for hepatologists. For these reasons, the national board of the Italian Society on Alcohol have reviewed the most recent data on the management of ESALD, SAAH and LT for ALD in patients with AUD, formulating a position paper with related recommendations regarding four issues of specific clinical interest in this field: (a) the management of hepatic encephalopathy in patients with AUD, and LT in patients with ESALD; (b) the management of SAAH; (c) the management of AUD in patients with ESALD and SAAH; (d) special populations: polydrug addicts.
在全球范围内，男性中酒精使用障碍（AUD）的患病率为 20-30%，女性中为 10-15%，而与酒精相关的肝脏疾病（ALD）导致的肝硬化占全球死亡人数的 0.9%，占肝硬化相关死亡人数的 47.9%。终末期 ALD（ESALD）是酒精性肝硬化的终末期，严重的急性酒精性肝炎（SAAH）是一种与大量饮酒相关的独特临床综合征。在某些情况下，ESALD 和 SAAH 可能需要进行肝移植（LT）。因此，对于 AUD 患者的 ESALD 和 SAAH 的管理可能是肝病学家临床技能的重要组成部分。基于这些原因，意大利酒精学会国家委员会审查了有关 AUD 患者的 ESALD、SAAH 和 LT 治疗的最新数据，针对该领域四个具有特定临床意义的问题制定了一份立场文件和相关建议：（a）AUD 患者肝性脑病和 ESALD 患者 LT 的管理；（b）SAAH 的管理；（c）ESALD 和 SAAH 患者 AUD 的管理；（d）特殊人群：药物滥用者。
