Finlayson N D
Royal Infirmary, Edinburgh, UK.
Baillieres Clin Gastroenterol. 1993 Sep;7(3):627-40. doi: 10.1016/0950-3528(93)90005-d.
The severity and range of histological liver lesions caused by alcohol abuse varies considerably; these lesions are not specific for alcoholic damage, and diagnosis of alcoholic liver disease depends on obtaining an adequate history of prolonged alcohol abuse and on excluding other known causes of liver disease. The clinical features of alcoholic liver disease vary greatly and they have been classified into various syndromes. However, the syndromes overlap, the histological features underlying them also overlap and they represent part of a wide clinical spectrum. Alcoholic fatty liver occurs more in younger patients and has a much better prognosis than alcoholic hepatitis or alcoholic cirrhosis, but the previous view that alcoholic fatty liver is an innocuous lesion can no longer be maintained. Alcoholic hepatitis and alcoholic cirrhosis cause more severe syndromes and more florid clinical features, and mortality is related to features of liver failure and variceal bleeding. Abstinence is the only means of ensuring the best possible survival.
酒精滥用所致肝脏组织学损伤的严重程度和范围差异很大；这些损伤并非酒精性损害所特有，酒精性肝病的诊断依赖于获取长期酒精滥用的充分病史，并排除其他已知的肝病病因。酒精性肝病的临床特征差异极大，已被分为多种综合征。然而，这些综合征相互重叠，其潜在的组织学特征也相互重叠，它们代表了广泛临床谱的一部分。酒精性脂肪肝在年轻患者中更为常见，其预后比酒精性肝炎或酒精性肝硬化好得多，但以往认为酒精性脂肪肝是无害病变的观点已不再成立。酒精性肝炎和酒精性肝硬化会导致更严重的综合征和更明显的临床特征，死亡率与肝衰竭和静脉曲张出血的特征相关。戒酒是确保最佳生存几率的唯一方法。
