Shearer Jessica, Johnson Amy, Masson Steven
Liver Unit, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Translational and Clinical Research Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK.
Frontline Gastroenterol. 2023 Aug 10;15(1):42-49. doi: 10.1136/flgastro-2022-102362. eCollection 2024 Jan.
Alcohol-related hepatitis (AH) is the most florid presentation of alcohol-related liver disease and carries a high short-term and long-term mortality rate. Specific treatment options remain inadequate. The current management approach for AH focuses on early identification, careful screening and treatment of infection, as well as identification of those patients who may benefit from corticosteroid therapy based on validated prognostic scoring systems. In recent years, there has been growing interest in exploring novel therapies for AH, which may offer alternative treatment options beyond the traditional approaches. Additionally, early liver transplantation (LT) has emerged as a promising option in selected cases with growing evidence supporting its role. In this review, we will discuss the current evidence base for the assessment and treatment of AH, and how these advances are shaping practice to improve outcomes in the UK.
酒精性肝炎(AH)是酒精性肝病最典型的表现形式,其短期和长期死亡率都很高。目前的具体治疗方案仍不完善。AH目前的管理方法侧重于早期识别、仔细筛查和治疗感染,以及根据经过验证的预后评分系统确定那些可能从皮质类固醇治疗中获益的患者。近年来,人们越来越有兴趣探索AH的新疗法,这些新疗法可能提供超越传统方法的替代治疗选择。此外,早期肝移植(LT)在某些选定病例中已成为一种有前景的选择,越来越多的证据支持其作用。在本综述中,我们将讨论AH评估和治疗的当前证据基础,以及这些进展如何正在改变英国的医疗实践以改善治疗结果。