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酒精性肝病实验室检查及远期预后观察 被引量:15

LABORATORY EXAMINATION AND LONG-TERM FOLLOW-UP STUDIES IN PATIENTS WITH ALCOHOL LIVER DISEASE
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摘要 病理检查诊断酒精性脂肪肝(AF)10例,酒精性肝炎(AH)15例,酒精性肝硬化(AC)15例,轻微病变(MC)5例,与病理及HBV-M诊断CAH10例比较。GGT试验显示AF平均240±52.5μmol/LAH381±18.4μmol/L。(最高1600μmol/L),AC205±60.5μmol/L,CAH76.9±20.7μmol/L。AF、AH与CAH比较差异显著(P<0.01)。AF、AH戒酒后,GGT恢复好转,再酗明显上升,结合嗜酒史,有诊断参考意义。甘氨胆酸试验(RIA)示AC增高显著(3258±50.2mg/L,最高7000g/L,与AH(1535±l9.2mg/L)比较(P<0.01),对判断预后有参考价值。AH病与AH2例较西方国家轻,AC年龄接近(48.11±14.2岁)。共随访1~12年(平均6.3年)。戒酒后AF、MC完全恢复,AC于继续酗酒后2-4年内死于肝衰竭,EVB与HCC死亡。戒酒为终身治疗,支持治疗辅之,而治疗乙醇依赖及戒酒综合征(AWS)乃达到戒酒的关键。 5 patients of alcohol liver dlsease(ALD) clinically and histologically diagnosed were divided into those groups:alcoholic fatty liver(AF)(n=10),alcoholic hcpatitis(AH)(n=15),alcoholic cirrhosis(AC)(n=15)and mild changes(MC)(n=15)on the basis of pathological changes and clinical findings.The amounts of alcohol consumed among these groups were not significantly different,However,the durations of alcohol consumption were Ionger in AH and AC than in AF patients.Tlie clinical features of the patients were quite similar to those reported from the West, except that AH was relatively mild in our patients, High elevation of GGT levels were declined to normal after withdrawal of alcohol and raised again after redrinkimg, GGT/ALP> l.5, ALT/AST>2.0 were useful for diagnosis of AF and AH.And high elevation of serum cholic acid levels were favourable for predicting the prognosis of ALD and development of AC。The follow-up period ranged 1 to 12 years(M:6.3 yrs).Ten AF and 5 MC patients completely recovered after withdrawal of alcohol consumption. Six AC and 2 AH patients dled of hepatic failure,EVB and HCC afler heavy redrinking within 2~4 years.Stop drinking is the lifelong treatment for ALD patients.
出处 《肝脏病杂志》 CSCD 1995年第4期210-213,共4页
关键词 酒精性肝病 谷氨酰转移酶 甘氨胆酸 脂肪肝 预后 Alcoholic liver diseases Gamma-glutamyl-transpeptidasie Cholic acid
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