Liu J D, Leung K W, Wang C K, Liao L Y, Wang C S, Chen P H, Chen C C, Yeh E K
Department of Medicine, Taipei Medical College Hospital, Taiwan.
Alcohol Clin Exp Res. 1998 May;22(S3 Pt 1):164S-169S. doi: 10.1111/acer.1998.22.s3_part1.164s.
Socioeconomic development has led to a progressive increase of alcohol consumption in Taiwan, with an accompanying increase in alcohol-related psychiatric problems, traffic accidents, and liver disease. The prevalent rates of alcohol dependence for Han Chinese and Fomosan aborigines were 0.1% and 1%, respectively in 1950. The rate of alcohol dependence increased to 23% for aborigines in 1995. The number of cases of death and serious injuries due to alcohol-related traffic accident has decreased, and the number of fatalities resulting from these accidents has decreased from third to eighth since the inception of a program of random traffic stops with alcohol breath test in 1997. Alcohol liver disease (ALD) was defined as daily alcohol consumption of 60 g, for a duration of longer than 5 years. We classified ALD patients into two groups: (1) those whose average daily consumption of alcohol exceeded 120 g for a duration longer than 15 years (group A); and (2) all other patients (group B). The case records of 33 cases of biopsy-confirmed ALD were obtained for study. The average of daily alcohol consumption in these cases was 160 g. All but one of these patients were male, age ranged from 26 to 69 years, with an average of 43.1. Clinically, ill-defined gastrointestinal symptoms were the most common presentation (61%), and hepatomegaly was the main physical sign (73%). The average mean corpuscular volume values of ALD and non-ALD patients were 102.3 +/- 10.94 and 94.5 +/- 8.1, respectively (p < 0.01). The mean corpuscular volume values of group A and group B were 102.9 +/- 9.7 vs. 96.5 +/- 9.11 (p < 0.05). Result from serum SGOT/SGPT and gamma-glutamyltransferase/alkaline phosphatase for ALD and non-ALD revealed statistically significant differences between these groups. Using the avidin-biotin complex technique, tissue IgA deposition for ALD patients was found to be different from that of non-ALD patients. Ten of 13 ALD patients vs. 2 of 13 non-ALD patients had continuous-form IgA deposition. Histologically, 45.5% of ALD patients had alcoholic cirrhosis, whereas alcoholic hepatitis was present in only 9.1% of patients. Overall, 88% of cases showed various severity of fatty metamorphosis.
社会经济发展导致台湾地区酒精消费量逐渐增加，与之相伴的是与酒精相关的精神问题、交通事故和肝脏疾病的增多。1950年，汉族和台湾原住民的酒精依赖患病率分别为0.1%和1%。1995年，原住民的酒精依赖率升至23%。自1997年实施随机设卡酒精呼气测试计划以来，与酒精相关的交通事故导致的死亡和重伤病例数量有所减少，此类事故造成的死亡人数从第三位降至第八位。酒精性肝病（ALD）定义为每日酒精摄入量60克，持续时间超过5年。我们将ALD患者分为两组：（1）平均每日酒精摄入量超过120克，持续时间超过15年的患者（A组）；（2）所有其他患者（B组）。获取了33例经活检确诊的ALD患者的病例记录用于研究。这些病例的平均每日酒精摄入量为160克。除1例患者外，所有患者均为男性，年龄在26至69岁之间，平均年龄为43.1岁。临床上，不明原因的胃肠道症状是最常见的表现（61%），肝肿大是主要体征（73%）。ALD患者和非ALD患者的平均红细胞体积值分别为102.3±10.94和94.5±8.1（p<0.01）。A组和B组的平均红细胞体积值分别为102.9±9.7和96.5±9.11（p<0.05）。ALD患者和非ALD患者血清谷草转氨酶/谷丙转氨酶以及γ-谷氨酰转移酶/碱性磷酸酶的结果显示两组之间存在统计学显著差异。使用抗生物素蛋白-生物素复合物技术，发现ALD患者的组织IgA沉积与非ALD患者不同。13例ALD患者中有10例与13例非ALD患者中有2例出现连续性IgA沉积。组织学上，45.5%的ALD患者患有酒精性肝硬化，而仅有9.1%的患者患有酒精性肝炎。总体而言，88%的病例表现出不同程度的脂肪变性。
