伴有威尼克脑病的酒精性肝病患者：一项多中心观察性研究。

Alcoholic Liver Disease Among Patients with Wernicke Encephalopathy: A Multicenter Observational Study.

机构信息

Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.

Department of Internal Medicine, Hospital Universitario de Salamanca-IBSAL, University of Salamanca, Salamanca, Spain.

出版信息

Drug Alcohol Depend. 2022 Jan 1;230:109186. doi: 10.1016/j.drugalcdep.2021.109186. Epub 2021 Nov 27.

DOI:10.1016/j.drugalcdep.2021.109186

PMID:34864357

Abstract

BACKGROUND

data regarding the association between Wernicke encephalopathy (WE) and alcoholic liver disease (ALD) are scarce in spite of alcohol consumption being the main risk factor for WE.

AIMS

to describe the frequency of ALD in a cohort of patients diagnosed with WE and alcohol use disorders (AUDs) and to compare the characteristics of WE patients with and without ALD.

METHODS

we conducted an observational study in 21 centers through a nationwide registry of the Spanish Society of Internal Medicine. WE Caine criteria were applied and demographic, clinical, and outcome variables were analyzed.

RESULTS

434 patients were included in the study, of which 372 were men (85.7%), and the mean age was 55 ± 11.8 years. ALD was present in 162 (37.3%) patients and we found a higher percentage of cases with tremor, flapping and hallucinations in the ALD group. A total of 22 patients (5.0%) died during admission (7.4% with ALD vs 3.7% without ALD; P = 0.087). Among the ALD patients, a relationship between mortality and the presence of anemia (Odds ratio [OR]=4.6 Confidence interval [CI]95% 1.1-18.8; P = 0.034), low level of consciousness (OR=4.9 CI95% 1.1-21.2; P = 0.031) and previous diagnosis of cancer (OR=10.3 CI95% 1.8-59.5; P = 0.009) was detected. Complete recovery was achieved by 27 patients with ALD (17.8%) and 71 (27.8%) without ALD (P = 0.030).

CONCLUSION

the association of WE and ALD in patients with AUDs is frequent and potentially linked to differences in clinical presentation and to poorer prognosis, as compared to alcoholic patients with WE without ALD.

摘要

背景

尽管酗酒是韦尼克脑病（WE）的主要危险因素，但关于 WE 与酒精性肝病（ALD）之间关联的数据仍然很少。

目的

描述在诊断为 WE 和酒精使用障碍（AUD）的患者队列中 ALD 的发生率，并比较 WE 患者中有无 ALD 的特征。

方法

我们通过西班牙内科学会的全国登记处，在 21 个中心进行了一项观察性研究。应用 WE Caine 标准，并分析了人口统计学、临床和结局变量。

结果

共纳入 434 例患者，其中 372 例为男性（85.7%），平均年龄为 55±11.8 岁。162 例（37.3%）患者存在 ALD，并且在 ALD 组中发现了更高比例的震颤、扑翼样震颤和幻觉病例。共有 22 例患者（5.0%）在住院期间死亡（ALD 患者中为 7.4%，无 ALD 患者中为 3.7%；P=0.087）。在 ALD 患者中，死亡与贫血（优势比 [OR]=4.6 95%置信区间 [CI]1.1-18.8；P=0.034）、意识水平低（OR=4.9 CI95% 1.1-21.2；P=0.031）和先前诊断为癌症（OR=10.3 CI95% 1.8-59.5；P=0.009）之间存在关联。ALD 患者中 27 例（17.8%）完全康复，无 ALD 患者中 71 例（27.8%）完全康复（P=0.030）。