Impact of moderate alcohol consumption on histological activity and fibrosis in patients with chronic hepatitis C, and specific influence of steatosis:: a prospective study
Impact of moderate alcohol consumption on histological activity and fibrosis in patients with chronic hepatitis C, and specific influence of steatosis:: a prospective study
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DOI：
10.1046/j.1365-2036.2003.01546.x
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发表时间：
2003-04-15
影响因子：
7.6
通讯作者：
Dhumeaux, D
中科院分区：
文献类型：
--
作者：
Hézode, C;Lonjon, I;Dhumeaux, D
目的：评价轻度至中度饮酒对慢性丙型肝炎患者组织学病变严重程度的影响。方法：记录260例慢性丙型肝炎患者每日酒精摄入量（无、1- 20g、21- 30g、31- 50g /d）、组织活动和纤维化情况。结果：中度（A2）或显著（A3）活动的患者比例从戒酒患者的53.8%逐渐增加到摄入量在31- 50g /d之间的86.5% （P = 0.003）。在多变量分析中，年龄在100 - 40岁之间、酒精摄入量在31 - 50克/天之间以及中度或重度脂肪变性与组织学活动独立相关。中度（F2）或显著（F3）纤维化或肝硬化（F4）的患者比例逐渐从戒断患者的29.0%增加到摄入量在31 - 50 g/天之间的67.6% （P < 0.001）。多变量分析还显示，酒精摄入量在31至50克/天之间，中度或重度脂肪变性和组织学活动与纤维化独立相关。酒精摄入对组织学病变的有害影响因性别而异。结论：本研究表明，活性和纤维化随酒精摄入量的增加而逐渐增加，即使是中度饮酒，男性低至31-50 g/d，女性低至21-50 g/d，也可能加重慢性丙型肝炎患者的组织学病变。
Aim: To evaluate the effects of minimal to moderate alcohol consumption on the severity of histological lesions in patients with chronic hepatitis C.Methods: Daily alcohol intake (none, 1-20, 21-30, 31-50 g/day) and histological activity and fibrosis were recorded in 260 patients with chronic hepatitis C.Results: The proportion of patients with moderate (A2) or marked (A3) activity increased gradually from 53.8% in abstinent patients to 86.5% for an intake between 31 and 50 g/day (P = 0.003). In multivariate analysis, age > 40 years, alcohol intake between 31 and 50 g/day and moderate or severe steatosis were independently related to histological activity. The proportion of patients with moderate (F2) or marked (F3) fibrosis or cirrhosis (F4) gradually increased from 29.0% in abstinent patients to 67.6% for an intake between 31 and 50 g/day (P < 0.001). Multivariate analysis also showed that alcohol intake between 31 and 50 g/day, moderate or severe steatosis and histological activity were independently related to fibrosis. The deleterious effect of alcohol intake on histological lesions differed according to gender.Conclusions: This study demonstrates that both activity and fibrosis gradually increase according to the amount of alcohol ingested, and that even moderate alcohol consumption, as low as 31-50 g/day in men and 21-50 g/day in women, may aggravate histological lesions in patients with chronic hepatitis C.