The alcohol withdrawal syndrome
The alcohol withdrawal syndrome
复制标题
DOI：
10.1016/s0140-6736(97)04572-8
复制
发表时间：
1997-06-28
期刊：
影响因子：
168.9
通讯作者：
Zador, D
中科院分区：
文献类型：
--
作者：
Hall, W;Zador, D
酒精戒断综合症 (AWS) 是一组体征和症状，通常发生在酒精依赖者最后一次饮酒后 6 至 24 小时内。如果因疾病或受伤而强制戒酒，则可能是无意发生的；如果某人因与酒精相关的疾病而自愿停止饮酒，或者作为戒酒和保持戒酒的前奏，则可能是故意发生的。该综合征（面板）的体征和症状主要（但不限于）是自主神经过度活跃的体征和症状，与酒精中毒的影响相反。它们代表中枢神经系统（CNS）对长期酒精中毒时发生的神经适应的稳态重新调整。 1 它们的严重程度从轻微到严重不等。 1AWS 的描述主要源自对人类长期醉酒后突然停止饮酒的影响的前瞻性观察。 2 此类研究现在被认为是不道德的。关于酒精戒断的对照观察性研究非常少，3 可能是因为有效的治疗方案降低了我们提高对其理解的动力。 AWS 的症状已根据不同的目的以不同的方式进行分类。在所有分类中，自主神经过度活跃的症状都包含在该综合征中，但分类在癫痫、幻觉和谵妄是否晚期以及 AWS, 1, 4 的主要症状是 AWS 管理不善的并发症，5 或单独的临床综合征方面有所不同。 6 一种流行的划分方法是分为三组症状。 7, 8 第一种是自主神经过度活跃，在最后一次饮酒后数小时内出现，通常在 24-48 小时内达到峰值。最常见的特征是颤抖、出汗、恶心、呕吐、焦虑和激动。第二组症状是神经元兴奋症状，包括通常在禁欲后 12-48 小时内发生的癫痫样发作（通常为大发作）。 9
The alcohol withdrawal syndrome (AWS) is a set of signs and symptoms that typically develops in alcoholdependent people within 6–24 h of their last drink. It may occur unintentionally if abstinence is enforced by illness or injury, or deliberately if the person voluntarily stops drinking because of an alcohol-related illness, or as a prelude to becoming and remaining abstinent. The signs and symptoms of the syndrome (panel) are largely, but not exclusively, those of autonomic hyperactivity, the reverse of the effects of alcohol intoxication. They represent a homoeostatic readjustment of the central nervous system (CNS) to the neuroadaptation that occurs with prolonged alcohol intoxication. 1 They vary in severity from mild to severe. 1The description of AWS is primarily derived from old prospective observations in human beings of the effects of the abrupt cessation of alcohol use after prolonged periods of intoxication. 2 Such studies would now be regarded as unethical. There have been very few controlled observational studies of alcohol withdrawal, 3 probably because an effective treatment regimen has reduced the incentive to improve our understanding of it. The symptoms of AWS have been classified in various ways for various purposes. In all classifications the symptoms of autonomic hyperactivity are included in the syndrome, but classifications differ with respect to whether seizures, hallucinations, and delirium are late and major symptoms of AWS, 1, 4 are complications of poorly managed AWS, 5 or are separate clinical syndromes. 6 A popular division is into three sets of symptoms. 7, 8 The first consists of those of autonomic hyperactivity which appear within hours of the last drink and usually peak within 24–48 h. The most common features are tremulousness, sweating, nausea, vomiting, anxiety, and agitation. The second set of symptoms are those of neuronal excitation, which include epileptiform seizures (usually grand mal) that usually occur within 12–48 h of abstinence. 9