Sherman D I, Williams R
Institute of Liver Studies, King's College School of Medicine, London, UK.
Br Med Bull. 1994 Jan;50(1):124-38. doi: 10.1093/oxfordjournals.bmb.a072871.
Despite recent advances in our knowledge of the mechanisms of alcohol-induced liver damage, abstinence from alcohol and supportive measures remain the mainstays of management for the majority of patients. Progress has been made in our understanding of ethanol metabolism, the role of acetaldehyde, and both genetic and environmental factors responsible for the variation in individual susceptibility to alcoholic liver disease. Evidence for the involvement of the immune system and the effects of alcohol on hepatic fibrosis are also reviewed. Recent therapeutic trials of corticosteroids in acute alcoholic hepatitis have confirmed their benefit in patients who have a high risk of mortality. For patients with end-stage cirrhosis, orthotopic liver transplantation is now an accepted therapy in selected patients who have a good prognosis for future abstinence.
尽管我们对酒精性肝损伤机制的认识最近有所进展，但戒酒和支持性措施仍然是大多数患者治疗的主要手段。我们在乙醇代谢、乙醛的作用以及导致个体对酒精性肝病易感性差异的遗传和环境因素的理解方面取得了进展。还综述了免疫系统参与的证据以及酒精对肝纤维化的影响。近期关于皮质类固醇治疗急性酒精性肝炎的试验证实了其对有高死亡风险患者的益处。对于终末期肝硬化患者，原位肝移植现在是某些对未来戒酒预后良好的选定患者可接受的治疗方法。
