Estruch R, Nicolás J M, Villegas E, Junqué A, Urbano-Márquez A
Department of Internal Medicine, Hospital Clínic, University of Barcelona, Spain.
Alcohol Alcohol. 1993 Sep;28(5):543-50.
Two-hundred and fifty chronically alcoholic men (mean age, 41 +/- 11 years) entering an alcoholism treatment program were studied. Detailed clinical history, nutritional assessment and measurement of muscle strength by electronic myometer were performed in each case. In addition, hepatic ultrasonography and liver biopsy, echocardiography and radionuclide cardiac scanning, and electrophysiologica testing of peripheral nerves were performed when there was clinical evidence of liver disease, cardiomyopathy or neuropathy, respectively. Alcoholic cirrhosis was diagnosed in 20 cases, skeletal myopathy in 117, dilated cardiomyopathy in 20 and peripheral neuropathy in 41 cases. No patients with chronic myopathy or cardiomyopathy showed either clinical or laboratory evidence of malnutrition. Patients with cirrhosis showed a significantly lower lean body mass than controls (P = 0.03) and significantly lower nutritional protein levels than those alcoholics without cirrhosis. Alcoholics with peripheral neuropathy had significantly lower anthropometric parameters and nutrition protein levels than their counterparts (P < 0.001). However, in the multivariate analysis, the only independent factor for developing these complications of alcoholism was the total lifetime dose of ethanol (P < 0.001). We conclude that alcohol-related diseases are common in asymptomatic alcoholic men and these diseases appear to be due to an accumulative toxic effect of ethanol. Age and nutritional status do not seem to play a part in the development of such diseases.
对250名进入戒酒治疗项目的慢性酒精中毒男性（平均年龄41±11岁）进行了研究。对每例患者都进行了详细的临床病史、营养评估以及使用电子肌动计测量肌肉力量。此外，当分别有肝病、心肌病或神经病变的临床证据时，还进行了肝脏超声检查和肝活检、超声心动图和放射性核素心脏扫描以及周围神经的电生理测试。诊断出酒精性肝硬化20例，骨骼肌病117例，扩张型心肌病20例，周围神经病变41例。慢性肌病或心肌病患者均未表现出营养不良的临床或实验室证据。肝硬化患者的瘦体重明显低于对照组（P = 0.03），营养蛋白水平也明显低于无肝硬化的酗酒者。患有周围神经病变的酗酒者的人体测量参数和营养蛋白水平明显低于其同龄人（P < 0.001）。然而，在多变量分析中，发生这些酒精中毒并发症的唯一独立因素是乙醇的终生总剂量（P < 0.001）。我们得出结论，酒精相关疾病在无症状的酗酒男性中很常见，这些疾病似乎是由于乙醇的累积毒性作用所致。年龄和营养状况似乎在这些疾病的发生中不起作用。
