Wodak A D, Saunders J B, Ewusi-Mensah I, Davis M, Williams R
Br Med J (Clin Res Ed). 1983 Nov 12;287(6403):1420-2. doi: 10.1136/bmj.287.6403.1420.
To determine the severity of dependence on alcohol in patients with alcoholic liver disease the severity of alcohol dependence questionnaire was administered to 193 patients with various types of alcoholic liver disease established histologically, in whom a detailed history of lifetime alcohol consumption was also obtained. Only 34 patients (18%) were classified as being severely dependent compared with 56% of patients without overt liver disease who were attending a neighbouring alcohol treatment unit. There was a significant correlation between the severity of dependence and mean daily alcohol consumption (r = 0.45 and 0.39 for men and women, respectively) but not duration of drinking. Dependence scores tended to be lower in patients with cirrhosis than in those with precirrhotic liver disease, but this difference reached significance only in women. These findings confirm that patients who develop chronic alcoholic liver disease are usually only mildly dependent on alcohol and support the hypothesis that patients who escape florid symptoms of alcohol dependence are at greater risk of developing liver damage because they are able to sustain a continual consumption of alcohol over many years.
为确定酒精性肝病患者对酒精的依赖程度，我们对193例经组织学确诊为不同类型酒精性肝病的患者进行了酒精依赖严重程度问卷调查，同时还获取了他们详细的终生饮酒史。与附近一家酒精治疗机构中56%无明显肝病的患者相比，只有34例患者（18%）被归类为重度依赖。依赖严重程度与平均每日酒精摄入量之间存在显著相关性（男性和女性的相关系数分别为0.45和0.39），但与饮酒时长无关。肝硬化患者的依赖评分往往低于肝硬化前期肝病患者，但这种差异仅在女性中具有统计学意义。这些发现证实，发生慢性酒精性肝病的患者通常仅对酒精有轻度依赖，支持了这样一种假说，即那些没有出现明显酒精依赖症状的患者发生肝损伤的风险更高，因为他们能够多年持续饮酒。
