Fisch H U, Lauterburg B H
Psychiatrische Poliklinik, Universität Bern.
Ther Umsch. 1998 Feb;55(2):80-3.
Only about 15% of the subjects abusing ethanol will eventually develop cirrhosis of the liver, suggesting that other factors in addition to the consumption of large quantities of ethanol play a role in the pathogenesis of alcoholic cirrhosis. Important contributors may be infection with hepatitis viruses, in particular HCV, protein-calorie malnutrition and immunologic factors. Abstinence improves the prognosis of patients with alcoholic cirrhosis, provided that the liver disease is not too far advanced. No pharmacotherapeutic intervention has shown a convincing improvement of the prognosis of alcoholic liver disease, so that the therapeutic efforts should be mainly directed towards abstinence. The patient with alcoholic liver disease needs support and guidance by the treating physicians. Supportive treatment with Disulfiram, Acamprosate or Naltrexon can help with achieving durable abstinence.
只有约15%滥用乙醇的受试者最终会发展为肝硬化，这表明除大量饮用乙醇外，其他因素也在酒精性肝硬化的发病机制中起作用。重要的促成因素可能是感染肝炎病毒，尤其是丙型肝炎病毒、蛋白质 - 热量营养不良和免疫因素。如果肝病不太严重，戒酒可改善酒精性肝硬化患者的预后。尚无药物治疗干预措施能令人信服地改善酒精性肝病的预后，因此治疗应主要针对戒酒。酒精性肝病患者需要治疗医生的支持和指导。使用双硫仑、阿坎酸或纳曲酮进行支持性治疗有助于实现持久戒酒。
