重症酒精性肝炎治疗进展

Research advances in severe alcoholic hepatitis

酒精性肝病在我国逐年增多,重症已成为肝衰竭的重要病因。本文就重症酒精性肝炎SAH的治疗进展进行介绍。戒酒和营养支持是SAH治疗的基础。激素、己酮可可碱、N-乙酰半胱氨酸、TNF-α抑制剂等干预性治疗手段在不断研究,但确切疗效尚存在争议,尚需要进一步高水准的临床观察验证。肝移植治疗是晚期酒精性肝炎患者的有效治疗方式,然而由于移植后复饮的问题,移植术前应进行严格的评估。

The cornerstone of therapy for alcoholic hepatitis are abstinence and nutritional support. Many therapeutic interventions have been studied in alcoholic hepatitis but have been unable to show convincing benefit. These interventions included, Corticosteroids,Pentoxifylline,N-acetylcysteine,inhibitors of TNF- α ,etc. High quality clinical trials research is essential in China. Liver transplantation （LT） confers a survival benefit in patients with ALD. However,alcohol relapse after transplantation remains a critical issue and drinking habits of transplanted patients need to be routinely screened.