Kim Eunju, Park Seung Ha
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Korean J Gastroenterol. 2020 Aug 25;76(2):60-64. doi: 10.4166/kjg.2020.76.2.60.
A diagnosis of alcohol-related liver disease (ALD) requires information on the history of excessive alcohol consumption (average intake of 40 g or more in men and 20 g or more in women a day). Furthermore, blood tests, such as GGT, AST, ALT, and mean corpuscular volume, and imaging studies, including abdominal ultrasound or transient elastography, are also useful. A liver biopsy can be useful for confirming the diagnosis and has prognostic value. ALD includes alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis, and in most cases, clinical manifestations can overlap. The prognostic scoring systems of ALD are limited mainly to alcoholic hepatitis, and the early mortality and treatment response can be predicted using various scoring systems. This review summarizes how to diagnose and evaluate the severity of ALD in clinical practice.
酒精性肝病（ALD）的诊断需要过量饮酒史的信息（男性平均每日摄入量40克或更多，女性20克或更多）。此外，血液检查，如γ-谷氨酰转移酶（GGT）、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）和平均红细胞体积，以及影像学检查，包括腹部超声或瞬时弹性成像，也很有用。肝活检有助于确诊且具有预后价值。ALD包括酒精性脂肪肝、酒精性肝炎和酒精性肝硬化，在大多数情况下，临床表现可能重叠。ALD的预后评分系统主要限于酒精性肝炎，使用各种评分系统可以预测早期死亡率和治疗反应。本综述总结了在临床实践中如何诊断和评估ALD的严重程度。
