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1.
应用ROC曲线评价酒精性肝病实验室诊断指标的价值   总被引:1,自引:0,他引:1  
目的探讨缺糖转铁蛋白(CDT)和GGT、ALT、AST对酒精性肝病(ALD)的诊断价值。方法选取38例ALD患者,40例非酒精性肝病(NALD),40例嗜酒者和40例健康人用离子交换色谱与免疫比浊法结合检测CDT,使用TBA-120FR全自动生化分析仪检测GGT、AST、ALT,用ROC曲线进行分析。结果CDT诊断ALD的ROC曲线下面积(AUC)为0.894,敏感性为0.821,特异性为0.797,而GGT这三者分别为0.804、0.800、0.633,ALT分别为0.533、0.314、0.541,AST分别为0.525、0.343、0.574。结论CDT、GGT对ALD的实验室诊断具有一定的价值,其中CDT优于GGT是最好的辅助诊断指标。  相似文献   

2.
目的:观察酒精性肝病患者血清缺糖基转铁蛋白(CDT)水平变化,探讨CDT诊断酒精性肝病的临床价值.方法:应用植物凝集素亲和层析法分离血清CDT和正常转铁蛋白(Tf),然后应用ELISA技术分别测定酒精性肝病组患者及正常对照组人员CDT和Tf,最后计算CDT/Tf值.结果:两组人员血清植物凝集素亲和层析洗脱图谱均显示两个洗脱峰;CDT存在于第一洗脱峰,Tf存在于第二洗脱峰,ELISA定量结果显示:酒精性肝病组患者血清CDT平均水平为5.05±1.64,Tf平均水平为54.91±40.94,CDT/Tf值为0.123,正常对照组人员血清CDT平均水平为4.78±1.03,Tf平均水平451.61±241.37,CDT/Tf值为0.0117,经统计学分析,P<0.05,差异有显著性意义.结论:酒精性肝病患者血清CDT水平及CDT/Tf值明显升高,CDT是诊断酒精性肝病良好的生化标志.  相似文献   

3.
目的:评估肝脏瞬时弹性成像、天冬氨酸转氨酶与血小板比值指数(APRI)及基于4因子的肝纤维化指数(FIB-4)对儿童非酒精性脂肪性肝病(NAFLD)肝纤维化的诊断价值。方法:选取湖南省儿童医院2015年8月至2020年10月已行肝穿刺病理活检的非酒精性脂肪性肝病100例进行回顾性研究,收集肝脏病理组织和临床资料。采用受...  相似文献   

4.
目的探讨非酒精性脂肪性肝病(NAFLD)伴发原发性肝癌(HCC)的发病率、临床特征和危险因素。方法采用回顾性分析的方法,选取该院住院确诊的1 092例HCC患者,参照2006-02中华医学会肝脏病分会脂肪肝和酒精性肝病学组《非酒精性脂肪性肝病诊疗指南》中关于NAFLD的临床诊断标准,从HCC患者中遴选出符合NAFLD诊断标准的72例患者,分析NAFLD相关HCC的发病率、临床表现及生化指标、影像学特征、生存率及影响预后的危险因素。结果 NAFLD伴发HCC患者共72例,占HCC患者的6.6%,年龄(60.52±10.21)岁,伴有2型糖尿病(T2DM)者35例,占48.6%(35/72),体重指数(BMI)≥26 kg/m2者28例,占38.9%(28/72),伴有高血压病者34例,占47.2%(34/72)。主要临床表现无明显特征性。其生存情况:随访NAFLD伴发HCC病例72例,死亡53例,1、2、3年生存率分别为68.47%、40.26%、30.52%。单因素分析BMI、T2DM、高血压病、谷丙转氨酶(ALT)、总胆红素(TBIL)、直接胆红素(DBIL)、谷氨酰转移酶(GGT)、胆碱酯酶(CHE)对NAFLD伴发HCC生存率比较差异有统计学意义(P〈0.05),可能是影响预后的危险因素。多因素分析显示BMI、T2DM是影响预后的独立危险因素。结论 NAFLD是HCC发生的原因之一,肥胖、T2DM是影响NAFLD伴发HCC预后的独立危险因素。  相似文献   

5.
酒精性肝病     
《传染病网络动态》2006,(9):139-140
超声对酒精性肝病诊断的价值——刘铭生等(山东招远市人民医院265400):《医用放射技术杂志》,2006,(2):85.86旧的:为了探讨超声检查对酒精性肝病诊断的临床应用价值。方法:对100例酒精性肝病患的超声图象进行综合分析。结果:酒精性脂肪肝79例、酒精性肝炎7例、酒精性肝硬化14例。结论:通过分析,确定超声检查酒精性肝病最简便、经济。】  相似文献   

6.
目的:评价水飞蓟宾治疗酒精性肝病的疗效和安全性。方法检索Cochrane图书馆、PubMed、OVID、CNKI、维普和万方等数据库中水飞蓟宾治疗酒精性肝病的随机对照研究,收录时间为1998年至2013年;使用RevMan 5.0软件进行Meta分析。结果共纳入8个研究,包括849例酒精性肝病患者;水飞蓟宾治疗组综合疗效优于一般保肝药的对照组,其OR为5.49(95%CI 3.51~8.58,P<0.00001);治疗组与对照组比,ALT、AST和GGT的加权均数差(WMD)分别为-6.20(95%CI -9.06~3.35)、-14.17(95%CI-17.08~11.25)和-32.32(95%CI-36.83~27.81),凝血酶原时间和白蛋白的WMD分别为2.11(95%CI 0.64~3.57)和1.42(95%CI 0.08~2.75),总胆固醇和甘油三脂的WMD 分别为-1.40(95%CI -1.61~1.19)和-0.35(95%CI -0.56~0.13),提示治疗组肝酶学指标、合成功能指标和降低血脂方面均显著优于对照组(P均<0.00001,);治疗组不良反应发生率为0.8%,对照组为1.7%。结论水飞蓟宾可显著改善酒精性肝病患者生化指标,且无明显不良反应。  相似文献   

7.
慢性肝炎     
《传染病网络动态》2007,(1):122-124
甘露消毒丹加减治疗慢性肝病附加酒精性肝损伤临床观察——孙刚等(吉林长春中医学院130021);《吉林中医药》。2006,26(5):18-19[目的:运用经方甘露消毒丹加硪治疗慢性肝病附加酒精性肝损伤,观察其疗效.方法:慢性肝病附加酒精性肝损伤患者60例,随机分为甘露消毒丹治疗组30例,护肝宁片观察组30例,疗程12周.对照治疗前后肝功主要指标ALT、AST、AKP、GGT、TBIL。  相似文献   

8.
全国酒精性肝病的多中心调查分析   总被引:23,自引:0,他引:23  
目的对全国酒精性肝病发病情况、临床特征等进行多中心回顾研究。方法按酒精性肝病诊疗指南标准,将全国7家医院2000—2004年902例确诊为酒精性肝病患者纳入研究。回顾调查酒精性肝病患者占同期住院肝病患者的构成比,分析酒精性肝病的易感因素。结果2000-2004年,酒精性肝病患者占同期住院肝病患者的病例构成比分别为2.4%、2.7%、2.8%、3.4%和4.3%;酒精性肝病以40~49岁者居多,每日摄入乙醇量为80~159g。饮酒年限以20~29年者居多;轻症酒精性肝病101例(11.2%)。酒精性脂肪肝204例(22.6%),酒精性肝炎260例(28.8%),酒精性肝硬化337例(37.4%)。酒精性肝硬化组的饮酒量、饮酒年限与其他三组差异有统计学意义(P〈0.05)。酒精性肝病患者常见临床表现为乏力、纳差、黄疸、腹胀、腹痛等;血清学改变以天冬氨酸转氨酶、丙氨酸转氨酶、了谷氨酰转肽酶、胆红素升高为主。约19.7%患者出现乙醇相关性精神障碍表现,11.9%出现乙醇戒断综合征.10.8%有乙醇性肌病表现;乙醇性心肌和胰腺损害分别占4.6%和3.1%;0.3%有乙醇性性功能障碍表现。结论酒精性肝病占同期住院肝病患者构成比呈逐年上升趋势,肝脏损害程度与饮酒量、饮酒年限相关.长期大量饮酒可造成多器官功能受损。  相似文献   

9.
背景:酒精性肝病(ALD)的发病率逐年递增,但缺乏特异性诊断指标,探索ALD各阶段的分子标志物变化趋势对其诊断和治疗具有重要意义。目的:探讨血清白细胞介素(IL)-12、糖缺失性转铁蛋白(CDT)、肝细胞生长因子(HGF)和内毒素在不同阶段ALD中的水平及其诊断价值。方法:选取2017年7月—2018年1月包头医学院第二附属医院收治的19例酒精性肝硬化(AC)、14例酒精性肝炎(AH)、16例酒精性脂肪肝(AFL)、16例亚临床患者,以15名体检正常者作为健康对照。采用ELISA法检测血清IL-12、CDT、HGF水平,鲎试验检测内毒素水平。以ROC曲线分析IL-12、CDT诊断ALD的价值。结果:AC、AH患者血清IL-12、内毒素水平显著高于AFL、亚临床和健康对照组(P 0. 05),AC、AH、AFL和亚临床组血清CDT水平均显著高于健康对照组(P 0. 05),AC患者血清HGF水平显著高于AH、AFL、亚临床和健康对照组(P 0. 05)。ALD患者血清IL-12、CDT、HGF与血清内毒素呈正相关(P 0. 05)。截断值为55. 06 pg/m L时,血清IL-12诊断ALD的敏感性和特异性分别为0. 86和0. 95;截断值为354. 41 pg/m L时,血清CDT诊断ALD的敏感性和特异性分别为0. 67和0. 88。结论:血清IL-12、CDT、HGF和内毒素在ALD不同阶段存在趋势性变化,IL-12、CDT诊断ALD具有较高的敏感性和特异性,可作为ALD早期诊断的标志物。血清HGF和内毒素对评估ALD严重程度具有一定的价值。  相似文献   

10.
目的:分析住院的酒精性肝病患者临床疾病的特点。方法对近10年收治的4379例各种酒精性肝病患者的疾病构成情况进行分析。结果2002年住院的酒精性肝病患者占住院的肝病患者的比例为1.74%,2006年为2.89%,2011年为4.18%,10年间上升了2.4倍;在酒精性肝病患者中,男性占97.69%(4278/4379);酒精性肝硬化、酒精性肝病(未分类)、轻症酒精性肝炎为3种最常见的病种,分别占70.66%、10.44%和9.96%,而重症酒精性肝炎、酒精性肝衰竭和酒精性脂肪肝占比为4%左右;酒精性肝硬化患者平均年龄为49.6岁,而酒精性肝病重叠非酒精性脂肪性肝病患者平均年龄为36.9岁,两者差异有统计学意义(P<0.01);轻症酒精性肝炎和酒精性脂肪肝治愈率分别为80.28%和91.58%,而重症酒精性肝炎为47.78%,差异有统计学意义(P<0.01)。结论住院的酒精性肝病患者占住院肝病患者的比例在不断上升,须重视对男性人群和疾病的早期干预。  相似文献   

11.
We tested the diagnostic validity of carbohydrate-deficient transferrin (CDT) as an indicator for relapse into elevated alcohol consumption among patients who were examined under follow-up treatment before (n= 147) and after (n= 102) orthotopic liver transplantation (OLT) in the outpatient-department of the University Hospital Department of Surgery in Hamburg-Eppendorf. CDT measurements were performed with two commercial kits in parallel (CDTect-RIA and CDT%-RIA). Short-term parameters of alcohol consumption (ethanol, methanol) indicated relapses into elevated alcohol consumption in 11.4% of the evaluated patients with alcoholic liver disease (ALD) before transplantation. Before OLT, median CDT values were determined to be elevated among patients with alcoholic as well as nonalcoholic end-stage liver diseases (NALD). Among patients with ALD, we found elevated CDT medians even in those who were successfully scheduled for OLT after long-term evidence of abstinence proved by biochemical short-term parameters and psychological tests. Both CDTect and CDT% assays had comparable low specificities in selected patient groups before transplantation. CDT% and CDTect were negatively correlated with the albumin level. Before the study ended, CDT was no longer implemented in the evaluation of whether an OLT should be administered. This was due to inconsistent results of CDT in ALD as well as NALD. After OLT, patients with ALD, as well as NALD, had statistically significant lower CDT medians than before OLT, which ranged within reference levels. We determined, according to CDT, elevated alcohol consumption subsequent to OLT in 4 of 13 patients with ALD who underwent transplantation during the study (median observation period: 10 months). CDT does not appear to be useful in evaluating patients before OLT. With regained specificity and high sensitivity in patients after OLT, CDT could be recommended as a standard instrument for quality control in patients with ALD after liver transplantation.  相似文献   

12.
Selenium in chronic liver disease.   总被引:2,自引:0,他引:2  
In order to assess the role of selenium (Se) in chronic liver disease, we have measured serum, urinary and hepatic selenium in a range of liver diseases and correlated them with nutritional status and conventional liver biochemistry. Serum Se levels (microgram/l +/- S.D.) were significantly lower in both alcoholic (63.6 +/- 18.2, p less than 0.0001) and non-alcoholic liver disease (NALD) (60.6 +/- 13.6, p less than 0.0001) compared to healthy controls (87.8 +/- 21.2) and non-malignant 'disease controls' (80.3 +/- 19.1). Hepatic Se levels (microgram/g of dry weight) were also reduced in both ALD (0.568 +/- 0.647, p less than 0.005) and NALD (0.863 +/- 0.308, p less than 0.005) compared to controls (1.227 +/- 0.296), 24-h urinary Se excretion (microgram) in ALD (24.6 +/- 10.7) and NALD (29.0 +/- 14.3) was similar to controls (30.3 +/- 8.7). Serum Se showed a highly significant positive correlation with albumin (p less than 0.001) in both ALD and NALD. Serum levels were also significantly correlated with anthropometric measurements. Dietary assessment of patients with primary biliary cirrhosis and low serum Se levels did not show a reduced dietary intake. Our data show that Se levels are low in liver disease irrespective of aetiology and suggest that these low levels are more likely to be related to overall nutritional status than to dietary intake.  相似文献   

13.
Serum antibodies reactive with neo-antigens generated during ethanol metabolism have been identified in patients with alcoholic liver disease (ALD), although their role in the pathogenesis of disease remains unclear. In this study, we characterized peripheral blood mononuclear cell (PBMC) T-cell and antibody responses to human serum albumin (HAS) adducted with acetaldehyde under reducing conditions (AcA-HSA) or with malondialdehyde (MDA-HSA) in patients with advanced ALD (AALD, n = 28), heavy drinkers with no liver disease (NALD, n = 14), and mild/moderate drinking controls (n = 22). Peak proliferative responses of PBMC were assessed in vitro by tritiated thymidine incorporation after the addition of optimized concentrations of antigen or OKT3. Antibody titers were determined by enzyme-linked immunosorbent assay (ELISA). MDA-HSA induced PBMC T-cell proliferation was significantly higher in ALD than in NALD or control patients. Moreover, 10 of 28 (36%) of ALD patients had significant T-cell proliferative responses to MDA-HSA compared to 0 of 14 (0%, P =.02) of the NALD group and 2 of 22 (9%, P <.05) of controls. No significant difference in PBMC T-cell response to Aca-HSA was seen between subject groups. Patients with positive cellular responses to MDA had higher serum anti-MDA antibody titers than those not exhibiting a positive cellular response (P <.005). In conclusion, the pattern of cellular and humoral responses to MDA adducts suggests that the development of these responses may be a susceptibility factor for the development of advanced alcoholic liver disease. The apparent importance of T-cell responses to MDA adducts suggests that oxidative stress may represent an important stimulus for the development of cellular immune responses associated with advanced ALD.  相似文献   

14.
Carbohydrate-deficient transferrin (CDT) measurements have been widely examined as a marker of excessive alcohol consumption, yet the information on the sensitivity of this method has remained controversial. In addition, little is known of the relationship of this marker and the severity of alcoholic liver disease (ALD). To clarify these Issues, we analyzed serum samples from 373 alcohol abusers, including 200 problem drinkers with no apparent liver pathology, 173 patients with clinical or morphological evidence of ALD, and 42 healthy controls. CDT was analyzed by anion-exchange chromatography followed by radioimmunoassay. At a specificity of 100%, the sensitivity of CDT was 36% in problem drinkers reporting a mean of 710 ± 80 (mean ± 2SE) g of ethanol/week, as compared with the sensitivities of 44% and 35% for γ-glutamyltranspeptidase (GGT) and mean corpuscular volume (MCV), respectively. In a subgroup of problem drinkers (n= 51) with the highest ethanol intakes (1160 ± 180 g of ethanol/week) and severe dependence, the sensitivity of CDT increased to 64%, compared with 55% for GGT and 39% for MCV. In ALD, the CDT values were significantly higher than in the alcoholics with nonliver pathology. However, when such patients were classified according to the clinical, laboratory, and morphological severity of liver disease, CDT was found to be primarily elevated in those with the early stage of ALD, such that there was a significant negative correlation between CDT and the combined morphological index of disease severity (rs= -0.315, p < 0.05). ALD markers of fibrogenesis were elevated more frequently than CDT, showing significant positive correlations with the indices of disease severity. Current data indicates that, although CDT concentration correlates with the amount of alcohol consumed, it lacks diagnostic sensitivity in alcohol abusers consuming < 100 g of alcohol per day, thus hampering its use as a screen for consumption in community samples. The finding that CDT is increased in an early phase of ALD may prove to be of diagnostic value.  相似文献   

15.
We meesured serum levels of carbohydrate deficient transferrin (CDT) in 420 subjects: 100 healthy blood donors, 82 healthy employses, 70 abstaining patients with different chronic nonalcoholic liver disease, 16 abstaining patients with alcoholic fatty liver, 50 abstaining patients with alcohotic liver cirrhosls, 25 abusing patients with alcoholic fatty liver, 41 abusing patients with alcoholic liver cirrhosis, and 36 patients with alcohol dependence syndrome with a daily ethanol consumption of 173 ± 120 g the last 4 weeks before blood was drawn. In controls the serum level of CDT was significantly higher in females compared with males (17.7 ± 5.1 and 13.7 ± 3.8 units/liter, respectively), and the upper normal limit was defined as 27 and 20 units/liter. Sixty-two of 102 (60.8%) abusing patients with alcoholic liver disease had increased levels of CDT compared with 1 of 66 abstaining (1.5%) patients with alcoholic liver disease, and 10 of 70 (14.3%) abstaining patients with nonalcoholic liver disease among them 3 with primary biliary cirrhosis and 2 with chronic autoimmune hepatitis. No correlation was found between serum CDT and γ-glutamyltranspeptidase (GGT), AST, ALT, and mean red cell volume (MCV). The sensitivity and specificity for serum CDT was 61 and 92%, respectively, compared with 85 and 18% for GGT and 70 and 66% for MCV. No advantage was gained by using the CDT/transferrin ratio. Our study confirms that CDT is a specific marker for chronic alcohol abuse, except in few patients with other chronic liver diseases. Serum CDT seems to be a better indicator of abstention than GGT; AST and MCV in patients with alcoholic liver disease. However, in our hands CDT is not so sensitive for alcohol abuse in patients with liver disease as reported earlier in unselected alcoholics  相似文献   

16.
目的探讨丙醛-乙醛加合物(MAA)是否参与了酒精性肝病(ALD)患者的免疫反应。方法采用酶联免疫吸附试验(ELISA)检测40例酒精性肝病患者、40例非酒精性肝病患者、30例无肝损害的重度嗜酒者、40例健康对照的血清中MAA加合物的循环抗体,并评价MAA加合物的免疫反应。结果酒精性肝病患者抗MAAIgG滴度比健康对照组明显增加(平均OD值分别为0.42±0.23、0.10±0.04,P〈0.001),非酒精性肝病及重度嗜酒者中抗HSA—MAAIgG抗体(平均OD值分别为0.14±0.08、0.13±0.08)与对照组相比没有显著性差异。在酒精性肝病患者中抗MAA抗体为阳性,而非酒精性肝病患者、重度嗜酒者和健康对照多数为阴性。结论MAA具有免疫原性,可引起肝脏自身免疫反应,导致肝损伤,是引起酒精性肝病的重要因素。  相似文献   

17.
BACKGROUND: Studies in experimental animals have indicated that chronic ethanol ingestion triggers the formation of antibodies directed against proteins modified with reactive metabolites of ethanol and products of lipid peroxidation. However, the nature and prevalence of such antibodies have not been compared previously in alcoholic patients. METHODS: Autoantibodies against adducts with acetaldehyde- (AA), malondialdehyde- (MDA), and oxidized epitopes (Ox) were examined from sera of 54 alcohol consumers with (n = 28) or without (n = 26) liver disease, and from 20 nondrinking controls. RESULTS: Anti-AA-adduct IgA and IgG antibodies were elevated in 64% and 31% of patients with biopsy-proven alcoholic liver disease (ALD, n = 28), respectively. The IgA titers were significantly higher than those from nondrinking controls (p < 0.001), or heavy drinkers without significant liver disease (p < 0.001). Anti-MDA adduct titers (IgG) were elevated in 70% of the ALD patients. These titers were significantly higher (p < 0.001) than those from nondrinking controls, or heavy drinkers without liver disease. Antibodies (IgG) against Ox epitopes occurred in 43% of ALD patients, and the titers also were significantly higher (p < 0.05) than those from nondrinking controls. The anti-AA and anti-MDA adduct titers in ALD patients correlated significantly with the combined clinical and laboratory index (CCLI) of liver disease severity (r(s) = 0.449, p < 0.05; r(s) = 0.566, p < 0.01, respectively), the highest prevalences of anti-AA-adducts (73%) and anti-MDA-adducts (76%) occurring in ALD patients with cirrhosis. CONCLUSIONS: The present results indicated that autoantibodies against several distinct types of protein modifications are generated in ALD patients showing an association with the severity of liver disease.  相似文献   

18.
OBJECTIVE: Cytokine interleukin-1beta plays a central role in the inflammation process. Serum levels of IL-1beta are elevated in patients with alcoholic liver disease (ALD), especially in those with cirrhosis and alcoholic hepatitis. Recently, the presence of genetic polymorphisms of this cytokine was confirmed. The aim of this study was to determine whether IL-1beta polymorphisms are associated with the development of ALD. METHODS: We examined the frequency of two polymorphisms in the IL-1beta gene located in promoter -511 and exon 5 +3953 locus by restriction fragment length polymorphisms in 142 male patients with ALD, 30 heavy drinkers without ALD, and 218 healthy controls. RESULTS: The carriers of -511 IL-1beta allele 2 were present significantly more often in patients with alcoholic cirrhosis than in those with noncirrhotic ALD (p = 0.026), heavy drinkers without ALD (p = 0.001), and healthy controls (p = 0.032). The frequencies of allele 2 and heterozygotes of +3953 polymorphism were both significantly higher in heavy drinkers without ALD than in patients with ALD (allele, p = 0.030; genotype, p = 0.027) and healthy controls (allele, p = 0.047; genotype, p = 0.043). The haplotype, IL-1beta -511 allele 2/+3953 allele 1 was associated with the development of alcoholic cirrhosis (p < 0.05). CONCLUSIONS: These results suggest that IL-1beta polymorphisms may be related to the development of ALD in Japanese alcoholics.  相似文献   

19.
Carbohydrate-deficient transferrin (CDT) has been proposed as a marker of alcohol abuse. However, its value in patients with associated liver disease is still controversial. The aim of the study was to investigate the usefulness of CDT as a marker of alcohol consumption in patients with liver disease. We measured serum levels of CDT and those of commonly used hematological and biochemical markers, mean corpuscular volume (MCV), transaminases (AST and ALT), and γ-glutamyltransferase in 179 male subjects divided into four groups: 45 active drinkers (13 with normal liver, 21 with fibrosteatosis, and 11 with liver cirrhosis), 45 abstinent chronic alcoholics (18 with and 27 without liver disease), 58 patients with nonalcoholic liver disease, and 31 healthy controls. Serum CDT in active alcoholics was 37.5 ± 3.6 units/liter, being significantly higher than that of abstinent alcoholics (20.3 ± 1.5 units/liter), patients with nonalcoholic liver disease (18.1 ± 1.1 units/liter), and controls (13.1 ± 0.8 units/liter). Contrary to the other markers, no significant differences were observed in CDT values in relation with the presence and severity of liver disease in either the active drinkers or in the abstinent alcoholics. The sensitivity and specificity of CDT as a marker of alcoholism in the series as a whole was 64% and 82%, respectively, similar to the best conventional marker, MCV (64 and 82%). In patients with liver disease, CDT maintained good sensitivity (72%) and specificity (83%). Receiver operating characteristic analysis confirmed that CDT had a similar diagnostic value to that of MCV, but better than γ-glutamyltransferase and transaminases for the detection of alcohol abusers. The good diagnostic efficacy of CDT remained unchanged when analyzing only patients with liver disease. We conclude that serum CDT is a good marker of alcoholism and is less influenced than the currently used biochemical markers for associated liver disease. Thus, CDT is an effective laboratory test to detect alcohol abuse regardless of the presence of alcoholic liver disease.  相似文献   

20.
OBJECTIVE: No systematic evaluation has been performed previously in the Scandinavian countries on patients transplanted for alcoholic liver disease (ALD). Data are limited on the impact of structured management of the alcohol problem on the risk of recidivism following transplantation in ALD. MATERIAL AND METHODS: A total of 103 ALD patients were compared with a control group of patients with non-alcoholic liver disease (NALD). The recidivism rates for ALD patients transplanted between 1988 and 1997 as well as after 1998 (institution of structured management) were compared. RESULTS: The median follow-up was 31 (6-60) months in the ALD group and 37 (12-63) months in the control group (NS). The overall survival rates at 1- and 5 years were, respectively, 81% and 69% for the ALD group and 87% and 83% for the non-alcoholic group. The proportion of patients with Child-Pugh C (75%) was higher in ALD patients than in NALD patients (44%) (p<0.01). Thirty-two (33%) ALD patients resumed taking some alcohol after transplantation; 17 patients (18%) were heavy drinkers. A multivariate analysis showed that: sex, age, marital and employment status, benzodiazepine use and a history of illicit drug abuse did not predict the risk of alcohol relapse post-Tx. Nineteen out of 40 (48%) patients transplanted before the start of structured management had resumed alcohol but 13 (22%) out of 58 after this intervention (p=0.002). CONCLUSIONS: ALD is a good indication for liver transplantation, with similar results in the ALD patients. Structured management of the alcohol problem before and after transplantation is important in minimizing the risk of recidivism.  相似文献   

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