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酒精相关性肝病:不断变化的概念与治疗。

Alcohol-Associated Liver Disease: Evolving Concepts and Treatments.

机构信息

AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Department of Gastroenterology and Liver, Liverpool Hospital, Sydney, NSW, Australia.

出版信息

Drugs. 2023 Nov;83(16):1459-1474. doi: 10.1007/s40265-023-01939-9. Epub 2023 Sep 25.

Abstract

Alcohol is a prominent cause of liver disease worldwide with higher prevalence in developed nations. The spectrum of alcohol-associated liver disease (ALD) encompasses a diverse range of clinical entities, from asymptomatic isolated steatosis to decompensated cirrhosis, and in some cases, acute or chronic liver failure. Consequently, it is important for healthcare practitioners to maintain awareness and systematically screen for ALD. The optimal evaluation and management of ALD necessitates a collaborative approach, incorporating a multidisciplinary team and accounting for concurrent medical conditions. A repertoire of therapeutic interventions exists to support patients in achieving alcohol cessation and sustaining remission, with complete abstinence being the ultimate objective. This review explores the existing therapeutic options for ALD acknowledging geographical discrepancies in accessibility. Recent innovations, including the inclusion of alcohol consumption biomarkers into clinical protocols and the expansion of liver transplantation eligibility to encompass severe alcohol-associated hepatitis, are explored.

摘要

酒精是全球范围内导致肝脏疾病的主要原因,在发达国家更为普遍。酒精相关性肝病(ALD)的范围广泛,包括从无症状的孤立性脂肪变性到失代偿性肝硬化,在某些情况下还会出现急性或慢性肝功能衰竭。因此,医疗保健从业者保持警惕并系统筛查 ALD 非常重要。优化 ALD 的评估和管理需要采用协作方法,结合多学科团队,并考虑到同时存在的医疗状况。有一系列治疗干预措施可以支持患者戒酒并维持缓解,完全戒酒是最终目标。本综述探讨了现有的 ALD 治疗选择,并认识到在可及性方面存在地域差异。探讨了包括将酒精摄入量生物标志物纳入临床方案以及扩大肝移植资格以纳入严重酒精相关性肝炎在内的最新创新。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc0a/10624727/23c5d1258a39/40265_2023_1939_Fig1_HTML.jpg

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