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