Wetterling T, Kanitz R D, Renner F, Fischer D
Department of Psychiatry, Medical University of Luebeck, Germany.
Alcohol Clin Exp Res. 1998 Aug;22(5):1053-6.
Alcohol withdrawal often causes severe complications. However, many addicts deny any abuse. Thus, the diagnosis of alcohol abuse frequently becomes difficult. Laboratory parameters are often used to support the diagnosis of alcohol abuse. Furthermore, laboratory parameters should facilitate the prediction of the severity of alcohol withdrawal syndrome (AWS). The most promising laboratory parameter indicating a recent elevated alcohol consumption is carbohydrate-deficient transferrin (CDT). The aim of this study was to examine whether the measurement of CDT at admission can indicate a higher risk for the development of a complicated AWS. The severity of AWS was assessed by the AWS scale, consisting of two subscales for somatic and mental symptoms. CDT was measured by different methods (radioimmunoassay and HPLC). The radioimmunoassay for CDT (CDTect) yielded the best prediction. Our results showed a weak correlation between CDTect and the severity of AWS. However, there were great gender differences. In men, CDTect had the highest positive predictive value for a severe AWS (86.7%), whereas in women mean corpuscular volume was the best predictor (77.8%). However, the sensitivity of CDTect in men (25.5%), as well as mean corpuscular volume in females (29.2%), was too low for a screening test in a general hospital.
酒精戒断常常会引发严重的并发症。然而，许多成瘾者否认存在任何滥用情况。因此，酒精滥用的诊断常常变得困难。实验室指标常被用于辅助酒精滥用的诊断。此外，实验室指标应有助于预测酒精戒断综合征（AWS）的严重程度。最有前景的表明近期酒精摄入量增加的实验室指标是缺糖转铁蛋白（CDT）。本研究的目的是检验入院时CDT的测量是否能表明发生复杂AWS的风险更高。AWS的严重程度通过AWS量表进行评估，该量表由躯体症状和精神症状两个子量表组成。CDT通过不同方法（放射免疫测定法和高效液相色谱法）进行测量。CDT的放射免疫测定法（CDTect）给出了最佳预测结果。我们的结果显示CDTect与AWS的严重程度之间存在微弱关联。然而，存在很大的性别差异。在男性中，CDTect对严重AWS的阳性预测值最高（86.7%），而在女性中，平均红细胞体积是最佳预测指标（77.8%）。然而，CDTect在男性中的敏感性（25.5%）以及平均红细胞体积在女性中的敏感性（29.2%）对于综合医院的筛查测试来说过低。
