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酒精使用障碍与COVID-19大流行相关的肝损伤

Alcohol use disorder and liver injury related to the COVID-19 pandemic.

作者信息

Marano Giuseppe, Traversi Gianandrea, Gaetani Eleonora, Pola Roberto, Claro Angelo Emilio, Mazza Marianna

机构信息

Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy.

Dipartimento di Medicina di Laboratorio, UOSD Genetica Medica, Ospedale Generale "San Giovanni Calibita" Fatebenefratelli, Rome 00186, Italy.

出版信息

World J Hepatol. 2022 Oct 27;14(10):1875-1883. doi: 10.4254/wjh.v14.i10.1875.

Abstract

Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components. Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte. The liver is the central organ in the metabolism of alcohol, a process that also involves other organs and tissues such as the brain, heart and muscles, but the most relevant organ is the liver. The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes, to cirrhosis and hepatocellular carcinoma. Alcohol abuse frequently leads to liver disease such as steatosis, steatohepatitis, fibrosis, cirrhosis, and tumors. Following the spread of coronavirus disease 2019 (COVID-19), there was an increase in alcohol consumption, probably linked to the months of lockdown and smart working. It is known that social isolation leads to a considerable increase in stress, and it is also recognized that high levels of stress can result in an increase in alcohol intake. Cirrhotic patients or subjects with liver cancer are immunocompromised, so they may be more exposed to COVID-19 infection with a worse prognosis. This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

摘要

酒精使用障碍是一种复杂且异质性的现象,可以从多个角度通过关注其不同组成部分来进行研究。酒精是一种肝毒素,其代谢会在肝细胞内产生深刻变化。肝脏是酒精代谢的核心器官,这一过程还涉及其他器官和组织,如大脑、心脏和肌肉,但最相关的器官是肝脏。与长期饮酒相关的肝脏解剖病理学改变范围从肝细胞中中性脂肪的简单积累到肝硬化和肝细胞癌。酒精滥用经常导致肝脏疾病,如脂肪变性、脂肪性肝炎、纤维化、肝硬化和肿瘤。2019年冠状病毒病(COVID-19)传播后,酒精消费量有所增加,这可能与数月的封锁和远程办公有关。众所周知,社会隔离会导致压力大幅增加,而且人们也认识到,高水平的压力会导致酒精摄入量增加。肝硬化患者或肝癌患者免疫功能低下,因此他们可能更容易感染COVID-19,且预后更差。本综述重点关注COVID-19大流行使酒精性肝损伤的出现成为一个重大的医学和社会问题这一事实。

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