Wetterling T, Kanitz R D
Klinik für Psychiatrie, Med. Universität zu Lübeck.
Fortschr Neurol Psychiatr. 1997 Aug;65(8):337-46. doi: 10.1055/s-2007-996338.
Many alcoholics deny any abuse, and hence it is often difficult to diagnose alcohol abuse. Laboratory parameters, such as gamma-glutamyltransferase (gamma-GT) and the mean corpuscular volume of erythrocytes (MCV), are often used to diagnose recent high alcohol intake. However, these parameters indicate elevated alcohol consumption only indirectly, e.g. if the elevation is due to an organ lesion caused by alcohol. In recent literature, CDT (carbohydrate-deficient transferrin) has been suggested as a most promising laboratory parameter indicating noxious alcohol consumption. The clinical value of CDT is compared to other "alcohol markers". CDT has the highest sensitivity and specificity in selected samples taken from alcoholics. However, the sensitivity of CDT is rather low in population surveys. Thus, CDT cannot be recommended for the screening of alcoholics. Furthermore, in view of the high cost of measurement, a close indication for application is urgent. Some examples of an indication in neurological and psychiatric diagnostics are critically discussed.
许多酗酒者否认有任何酗酒行为,因此往往难以诊断出酒精滥用情况。实验室指标,如γ-谷氨酰转移酶(γ-GT)和红细胞平均体积(MCV),常被用于诊断近期大量饮酒。然而,这些指标只是间接表明酒精摄入量增加,例如,如果升高是由酒精引起的器官病变所致。在最近的文献中,缺糖转铁蛋白(CDT)被认为是最有希望表明有害酒精摄入的实验室指标。将CDT的临床价值与其他“酒精标志物”进行了比较。在从酗酒者身上采集的特定样本中,CDT具有最高的敏感性和特异性。然而,在人群调查中,CDT的敏感性相当低。因此,不推荐使用CDT来筛查酗酒者。此外,鉴于测量成本高昂,迫切需要明确其应用指征。对神经科和精神科诊断中的一些应用指征实例进行了批判性讨论。