Lefkowitch J H, Fenoglio J J
Hum Pathol. 1983 May;14(5):457-63. doi: 10.1016/s0046-8177(83)80293-7.
The authors examined in detail the clinical and laboratory data and pathologic findings for 12 patients with alcoholic cardiomyopathy who were autopsied in the preceding ten years to determine the types of liver disease prevalent in this population. Neither alcoholic hepatitis nor cirrhosis was present in any patient, and most of the hepatic changes could be related to the effects of acute and chronic congestive heart failure. The major hepatic lesions included centrilobular congestion and/or ischemic necrosis, cardiac sclerosis (fibrosis about central veins and in perisinusoidal spaces), mild canalicular cholestasis, portal fibrosis, and nodular regenerative hyperplasia. This last finding may account for macroscopic nodularity resembling cirrhosis as well as portal hypertension in patients with alcoholic cardiomyopathy. Although alcoholic cardiomyopathy and alcoholic hepatitis or cirrhosis were mutually exclusive in the patients studied, the factors responsible for this are at present uncertain.
作者详细研究了12例酒精性心肌病患者的临床、实验室数据及病理结果，这些患者于过去十年间接受了尸检，以确定该人群中常见的肝病类型。所有患者均未出现酒精性肝炎或肝硬化，大多数肝脏变化可能与急慢性充血性心力衰竭的影响有关。主要的肝脏病变包括小叶中心充血和/或缺血性坏死、心脏硬化（中央静脉周围和窦周间隙纤维化）、轻度胆小管胆汁淤积、门脉纤维化和结节性再生性增生。最后这一发现可能解释了酒精性心肌病患者中类似肝硬化的宏观结节以及门脉高压的原因。虽然在所研究的患者中酒精性心肌病与酒精性肝炎或肝硬化相互排斥，但目前尚不清楚其原因。
