Recent advances in alcoholic hepatitis.
Recent advances in alcoholic hepatitis.
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DOI：
10.12688/f1000research.20394.1
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发表时间：
2020-01-01
期刊：
影响因子：
--
通讯作者：
Duarte-Rojo, Andres
中科院分区：
文献类型：
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作者：
Rachakonda, Vikrant;Bataller, Ramon;Duarte-Rojo, Andres
酒精性肝炎是酒精性肝病最严重的临床表现。由于缺乏有效的药物治疗，酒精性肝炎预后不良，其康复主要依赖于戒酒。随着酒精使用障碍的普遍增加，酒精性肝炎对社会和医疗费用的影响预计将显着增加。预后因素和肝活检可以帮助及时诊断，确定皮质类固醇的资格和反应，以及预测和移植转诊。尽管最近在酒精性肝炎病理生理学方面的发现令人鼓舞，并可能为新的治疗方式铺平道路，但应强调考虑及时识别和治疗肝脏相关并发症、传染性和代谢性疾病、营养不良和成瘾咨询的多学科方法。除了正确选择候选者外，移植计划还应提供足够的移植后成瘾支持，以使酒精性肝炎的早期肝移植成为未来十年最终清醒的经历。
Alcoholic hepatitis is the severest clinical presentation of alcoholic liver disease. Lacking an effective pharmacologic treatment, alcoholic hepatitis is associated with a poor prognosis and its recovery relies mostly on abstinence. With alcohol use disorder being universally on the rise, the impact of alcoholic hepatitis on society and health-care costs is expected to increase significantly. Prognostic factors and liver biopsy can help with timely diagnosis, to determine eligibility and response to corticosteroids, and for prognostication and transplant referral. Although recent discoveries in the pathophysiology of alcoholic hepatitis are encouraging and could pave the way for novel treatment modalities, a multidisciplinary approach considering timely identification and treatment of liver-related complications, infectious and metabolic disease, malnutrition, and addiction counseling should be emphasized. Apart from proper selection of candidates, transplant programs should provide adequate post-transplant addiction support in order to make of early liver transplantation for alcoholic hepatitis the ultimate sobering experience in the next decade.