酒精性肝炎与肝硬变的临床及预后观察

本文对近年来收治的25例酒精性肝病（ALD）的临床及预后进行了分析，其中酒精性肝炎（AH）10例，酒精性肝硬变（AC）10例，酒精性脂肪肝（AF）5例，并对该病的临床表现，实验室检查，B超等进行了探讨。作者认为戒酒是治疗ALD的紧要环节，戒酒是终生治疗，而治疗乙醇依赖状态和戒酒综合征是起到戒酒的关键。

CLINICAL AND FOLLOW UP STUDIES ON ALCOHOLIC HEPATITIS AND ALCOHOLIC LIVER CIRRHOSIS

Between January 1984 and December 1991,25 consecutive, histologically diagnosed patients,median age 48 years(range 17 -69)were prospectively studied. The patients were divided into those having alcoholic hepatitis (AH ,n= 10) .alcoholic liver cirrhosis (AC, n = 10)and alcoholic fatty liver(AF,n = 5)on the basis of their histological findings. All the patients were males,those AF being younger than those with AH and AC. The amount of alcohol consumption of AF,AH and AC was not significantlly different. By contrast,the duration of alcohol consumption was significantly different between the AF and AH and AC patients. The clinical features of the patients were quiet similar to those reported from the west except that AH was relatively milder in our patients. Intake of poor of quality country liquor were quite common in the majority. Follow -up period was 2 - 6 years. 6 death of 10 AC patients with continued alcohol consumption in 2-4 years. Among these,5 of 6 AC patients with Child-pugh C grade,portal hypertention and esophageal varices died and 2 died of HCC. 1 of AH died of hepatic failure after continued heavy alcohol consumption .All 5 AF patients recovered after withdrawal of alcohol. Survival is adversely affected by the severity of liver disease at diagnosis,the cont-nued consumption of alcohol and support treatment. These observations indicate that discontinuation of heavy alcohol consumption and treatment of alcohol withdrawal syndrome often results in improvement of liver lesions in patients with alcoholic liver disease.