Thaler H
Nutr Metab. 1977;21(1-3):196-93.
Alcoholic liver damage is only produced by constant alcohol intake. Close dose and time relationships are apparent. For many years, alcoholic fatty liver is the only noticeable alteration. It is completely reversible in 2-4 weeks when ethanol intake is stopped. After about 6 years of chronic abuse alcoholic hepatitis may develop. Once established it progresses within weeks or months to cirrhosis if ethanol intake is not discontinued. On the other hand, alcoholic hepatitis heals under complete abstenence from alcohol with unimportant fibrosis. After over-indulgence in alcohol over a period of 22 years, there is a 50% probability of cirrhosis. This shows clearly that the resistance of the liver to alcohol varies considerably in different individuals. Even in early stages of alcoholic cirrhosis the prognosis is reasonable. If these patients observe complete abstenence from ethanol, their life expectation is only slightly different from the average of the population. The extent of the consumption of alcohol is of decisive importance for the development of cirrhosis. New and very careful investigations reveal that the susceptibility to alcohol is different in both sexes. For men the danger level would thus appear to be around 60 g and for women around 20 g of pure alcohol a day. Beyond these critical levels the morbidity of cirrhosis multiplies almost in geometric progression with increasing amounts of ethanol.
酒精性肝损伤仅由持续饮酒引起。剂量和时间的密切关系很明显。多年来，酒精性脂肪肝是唯一明显的改变。停止摄入乙醇后，在2 - 4周内它完全可逆。经过约6年的慢性酗酒，可能会发展为酒精性肝炎。一旦形成，如果不停止摄入乙醇，它会在数周或数月内发展为肝硬化。另一方面，酒精性肝炎在完全戒酒的情况下会愈合，仅有轻微纤维化。在22年过度饮酒后，患肝硬化的概率为50%。这清楚地表明，肝脏对酒精的耐受性在不同个体中差异很大。即使在酒精性肝硬化的早期阶段，预后也是合理的。如果这些患者完全戒酒，他们的预期寿命与普通人群的平均预期寿命仅有轻微差异。酒精摄入量对于肝硬化的发展起着决定性作用。新的、非常细致的研究表明，男女对酒精的易感性不同。因此，对男性来说，危险水平似乎约为每天60克纯酒精，对女性来说约为每天20克纯酒精。超过这些临界水平，随着乙醇摄入量的增加，肝硬化的发病率几乎呈几何级数增长。
