酒精性肝病常见临床综合征

Alcoholic liver disease: common clinical syndromes

酒精性肝病仅次于病毒性肝硬化已经成为终末期肝病的重要病因,但过量饮酒对身体造成的损伤并没有得到广泛关注,特别是一些中晚期的临床综合征,如马德龙综合征、假性布加综合症、酒精诱发的骨病、酒精戒断综合征等已经显现,临床上还不能得到准确认识和及时治疗,导致一些不可逆的损伤。通过介绍这4种综合征的临床表现、可能机制、治疗原则,旨在提高临床医师重视这些过量饮酒的信号,及早预防和阻止酒精性肝硬化的发生与发展;对于酒精戒断综合征的早期认识和及时有效的治疗,不仅能够减少误诊误治,还可减少重症监护状态下患者的病死率。

Alcoholic liver disease （ALD） has become a major cause of end - stage liver disease after viral liver cirrhosis. However, the im- pairments due to excessive alcohol intake have not drawn much attention, especially some clinical syndromes that occur in the advanced stage of ALD, such as Madelung syndrome, pseudo Budd - Chiari syndrome, hepatic osteodystrophy, and alcohol withdrawal syndrome （AWS）. There is no accurate recognition and timely treatment of these syndromes, thus leading to irreversible damage. The clinical manifestation, possible mechanism, and therapeutic principle of the four syndromes are reviewed, aiming to increase the clinicians＇ awareness of these sig- nals of excessive drinking and to prevent the development and progression of ALD. Early diagnosis of AWS, as well as timely, effective treat- ment, can not only reduce misdiagnosis and mistreatment, but also reduce the mortality of patients under intensive care.