[Progress in the clinical treatment of alcoholic hepatitis]

Zhonghua Gan Zang Bing Za Zhi. 2022 Jun 20;30(6):672-675. doi: 10.3760/cma.j.cn501113-20210102-00003.
[Article in Chinese]

Abstract

Alcoholic hepatitis is a severe and life-threatening systemic inflammatory response syndrome, which has a high incidence and mortality rate worldwide. The severity ranges from asymptomatic liver biochemical disturbances to fulminant liver failure or death; however, there are few effective therapeutic interventions. Maddrey discriminant function not only predicts short-term mortality, but it also guides clinicians to choose appropriate alcoholic hepatitis-specific treatments. Alcohol abstinence, nutritional support, psychological counseling, and infection prevention remain the cornerstones for alcoholic hepatitis treatment. Corticosteroids remain the mainstay of treatment when patients have a good appetite and normal serum creatinine levels, but early liver transplantation is the only life-saving option for steroid-unresponsive patients. New studies have found that gut microbiota is an important therapeutic targets in patients with alcohol hepatitis, and N-acetylcysteine, granulocyte colony-stimulating factor, and metadoxine as adjunctive therapy have a positive effect on patient survival.

酒精性肝炎是一种严重危及生命的全身炎症反应综合征,在世界范围内具有较高的发病率和病死率,严重程度从无症状的肝脏生物化学紊乱到暴发性肝衰竭或死亡,但有效的治疗方法却很少。Maddrey判别函数不仅能预测酒精性肝炎的短期病死率,还能指导临床医生选择适当的特异性治疗方案。戒酒、营养支持、心理疏导和感染的防治仍然是治疗酒精性肝炎的基石。当患者食欲良好且血清肌酐水平正常时,皮质类固醇仍然是治疗的主要手段,早期肝移植是对类固醇无反应患者的唯一救命选择。新的研究将肠道微生物群作为酒精性肝炎的重要治疗靶点,N-乙酰半胱氨酸、粒细胞集落刺激因子和美他多辛,可以作为辅助治疗,对患者生存有积极影响。.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Alcohol Abstinence
  • Hepatitis, Alcoholic* / diagnosis
  • Hepatitis, Alcoholic* / therapy
  • Humans
  • Liver Transplantation*
  • Severity of Illness Index

Substances

  • Adrenal Cortex Hormones