Liu L L, Tong J, Wang Bingyuan
Department of Gastroenterology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021, China.
Department of Gastroenterology, the First Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 Jun 20;30(6):672-675. doi: 10.3760/cma.j.cn501113-20210102-00003.
Alcoholic hepatitis is a severe and life-threatening systemic inflammatory response syndrome, which has a high incidence and mortality rate worldwide. The severity ranges from asymptomatic liver biochemical disturbances to fulminant liver failure or death; however, there are few effective therapeutic interventions. Maddrey discriminant function not only predicts short-term mortality, but it also guides clinicians to choose appropriate alcoholic hepatitis-specific treatments. Alcohol abstinence, nutritional support, psychological counseling, and infection prevention remain the cornerstones for alcoholic hepatitis treatment. Corticosteroids remain the mainstay of treatment when patients have a good appetite and normal serum creatinine levels, but early liver transplantation is the only life-saving option for steroid-unresponsive patients. New studies have found that gut microbiota is an important therapeutic targets in patients with alcohol hepatitis, and N-acetylcysteine, granulocyte colony-stimulating factor, and metadoxine as adjunctive therapy have a positive effect on patient survival.
酒精性肝炎是一种严重且危及生命的全身炎症反应综合征，在全球范围内发病率和死亡率都很高。其严重程度从无症状的肝脏生化紊乱到暴发性肝衰竭或死亡不等；然而，有效的治疗干预措施却很少。马德雷判别函数不仅能预测短期死亡率，还能指导临床医生选择合适的酒精性肝炎特异性治疗方法。戒酒、营养支持、心理咨询和预防感染仍然是酒精性肝炎治疗的基石。当患者食欲良好且血清肌酐水平正常时，皮质类固醇仍然是主要的治疗方法，但早期肝移植是对类固醇无反应患者唯一的救命选择。新研究发现，肠道微生物群是酒精性肝炎患者的重要治疗靶点，N-乙酰半胱氨酸、粒细胞集落刺激因子和美他多辛作为辅助治疗对患者生存有积极影响。
