Assessment of liver histology in chronic alcoholics with and without hepatitis C virus infection
Assessment of liver histology in chronic alcoholics with and without hepatitis C virus infection
复制标题
DOI：
10.1023/a:1010671300507
复制
发表时间：
2001-07-01
影响因子：
3.1
通讯作者：
Anand, BS
中科院分区：
文献类型：
--
作者：
Anderson, S;Nevins, CL;Anand, BS
酒精性肝病患者丙型肝炎病毒（HCV）感染的患病率很高。酒精性肝病和HCV感染患者肝脏的组织学表现得到了很好的描述。然而，慢性酒精滥用和HCV感染双重病理个体的肝脏组织学尚不清楚。本研究的目的是检查这个问题，以确定是否有任何特定的组织学特征和血清生化异常之间的相关性，在这些患者中看到。86名慢性酗酒者，65名丙型肝炎病毒感染者和21名未感染者纳入研究。所有患者均有重度酒精滥用史（每天摄入80克或更多乙醇至少10年）。收集每位患者的以下数据：人口统计信息（年龄、性别、种族）、酒精摄入量和持续时间、生化结果和肝活检异常（包括组织活动指数（HAI）评分）。感染hcv的酗酒者较年轻（P = 0.05），非裔美国人多于白种人（P < 0.01）。与HCV感染者相比，未感染的酗酒者的饮酒量显著增加（P < 0.05）。HCV感染患者的肝脏组织学显示，小叶内坏死（P = 0.008）和门静脉周围炎症（P = 0.004）的HAI评分较高。慢性肝炎和局灶性淋巴细胞聚集的特征在hcv感染的酗酒者中更为常见（P = 0.001）。相比之下，未感染的酗酒者出现肝硬化的比例高于丙型肝炎病毒感染者（P = 0.05）。hcv感染的酗酒者肝纤维化组织学表现和总HAI评分与血清白蛋白和血小板计数有显著相关性。慢性酒精中毒并丙型肝炎病毒感染有特定的组织学表现，通常可以帮助区分这些患者与未感染的酒精中毒。相关性分析表明，在各种实验室检查中，血清白蛋白和血小板计数在组织学上是肝损伤严重程度的最佳预测指标。在慢性酗酒者中，肝硬化的发生与酒精摄入量的关系大于与丙型肝炎病毒感染的关系。
Patients with alcoholic liver disease have a high prevalence of hepatitis C virus (HCV) infection. The histological appearances of the liver in patients with alcoholic liver disease and HCV infection are well described. However, liver histology in individuals with dual pathology, both chronic alcohol abuse and HCV infection, is less well understood. The purpose of the present study was to examine this issue acid to determine if there is any correlation between specific histological features and the serum biochemical abnormalities seen in these patients. Eighty-six chronic alcoholics, 65 with HCV infection and 21 uninfected subjects, were included in the study. All patients had history of heavy alcohol abuse (consuming 80 g or more of ethanol a day for at least 10 years). The following data were collected on each patient: demographic information (age, gender, race), the amount and duration of alcohol intake, biochemical results, and liver biopsy abnormalities including the histological activity index (HAI) score. HCV-infected alcoholics were younger (P = 0.05) and were more often African American than Caucasian (P < 0.01). Alcohol consumption was significantly greater in uninfected alcoholics compared to those with HCV infection (P < 0.05). Liver histology in subjects with HCV infection showed higher HAI scores for intralobular necrosis (P = 0.008) and periportal inflammation (P = 0.004). Features of "chronic hepatitis" and focal lymphoid aggregates were more frequent in HCV-infected alcoholics (P = 0.001 for each). By contrast, cirrhosis was present in a higher proportion of uninfected alcoholics compared to those with HCV infection (P = 0.05). Histological findings of hepatic fibrosis and total HAI score showed a significant correlation with serum albumin and platelet count in HCV-infected alcoholics. Chronic alcoholics with HCV infection have specific histological appearances that can usually help distinguish these patients from uninfected alcoholics. Correlation analysis indicates that of the various laboratory tests, serum albumin and platelet counts are the best predictors of the severity of liver damage at histology. In chronic alcoholics, the development of cirrhosis is related more to the amount of alcohol consumed than to the presence of HCV infection.