Madhusudhan Guggilla, Singh Kartikeya R, Panda Om, Patra Priyadarshee
Department of Psychiatry, Military Hospital Jammu, Jammu and Kashmir, India.
Department of Psychiatry, Command Hospital Kolkata, West Bengal, India.
Ind Psychiatry J. 2024 Jul-Dec;33(2):360-365. doi: 10.4103/ipj.ipj_264_24. Epub 2024 Dec 17.
Alcohol-related liver disease contributes significantly to global mortality and healthcare costs, underscoring the urgency of early detection and non-invasive diagnostic tools such as transient elastography.
This study aimed to investigate the correlation between the severity of alcohol dependence syndrome (ADS) and liver dysfunction assessed via transient elastography in newly diagnosed patients.
From October 2019 to September 2021, a cross-sectional observational study was conducted on 58 inpatients diagnosed with ADS according to International Classification of Diseases-10 criteria. The severity of alcohol dependence was assessed using the Severity of Alcohol Dependence Questionnaire (SADQ), serum biochemical markers, and liver stiffness measured by transient elastography within 96 hours of admission and again after four weeks of enforced abstinence. Data were analyzed using Statistical Package for Social Sciences, with descriptive statistics applied to socio-demographic and clinical data. Paired t-tests compared biochemical markers, and Spearman rank correlation analyzed the relationship between SADQ scores and liver stiffness at admission and after abstinence.
Initial SADQ scores indicated moderate alcohol dependence in 55% of participants. According to Alcohol Use Disorders Identification Test, 38% had a medium-to-severe risk of harmful alcohol consumption. Liver fibrosis assessment showed that 63.8% had no or mild fibrosis on day 1, increasing to 81.0% by day 28. Moderate to advanced fibrosis (measured above 7.5 kilopascal) decreased from 8.6%, 12.1%, and 15.5% on day 1 to 3.4%, 5.2%, and 10.3% on day 28, respectively. There was a statistically significant ( < 0.05) reduction in serum biochemical markers and mean liver stiffness after four weeks of abstinence.
The study underscores that the greater severity of alcohol dependence correlates with more pronounced liver function impairments and stiffness. Transient elastography indicated significant liver fibrosis in actively drinking patients, with notable improvement after one month of abstinence.
酒精性肝病对全球死亡率和医疗成本有重大影响，凸显了早期检测以及诸如瞬时弹性成像等非侵入性诊断工具的紧迫性。
本研究旨在调查新诊断患者中酒精依赖综合征（ADS）的严重程度与通过瞬时弹性成像评估的肝功能障碍之间的相关性。
2019年10月至2021年9月，对58例根据国际疾病分类第10版标准诊断为ADS的住院患者进行了一项横断面观察性研究。使用酒精依赖严重程度问卷（SADQ）、血清生化标志物以及入院96小时内和强制戒酒四周后通过瞬时弹性成像测量的肝脏硬度来评估酒精依赖的严重程度。使用社会科学统计软件包对数据进行分析，描述性统计应用于社会人口统计学和临床数据。配对t检验比较生化标志物，Spearman等级相关性分析入院时和戒酒前后SADQ评分与肝脏硬度之间的关系。
初始SADQ评分表明55%的参与者为中度酒精依赖。根据酒精使用障碍识别测试，38%的人有中度至重度有害饮酒风险。肝纤维化评估显示，第1天63.8%的人无或有轻度纤维化，到第28天增至81.0%。中度至重度纤维化（测量值高于7.5千帕斯卡）从第1天的8.6%、12.1%和15.5%分别降至第28天的3.4%、5.2%和10.3%。戒酒四周后，血清生化标志物和平均肝脏硬度有统计学意义的降低（<0.05）。
该研究强调酒精依赖程度越高，与越明显的肝功能损害和肝脏硬度相关。瞬时弹性成像表明正在饮酒的患者有明显肝纤维化，戒酒一个月后有显著改善。
