[与酒精相关的肝炎:2025年为临床医生更新]
Guillaume Mellina1, Damien Le Peillet1, Pierre-Auguste Petignat1
1Service de médecine interne générale, Centre hospitalier du Valais romand, Hôpital de Sion, 1951 Sion.
Revue medicale suisse
|February 5, 2026
概括
酒精相关性肝炎是最严重的肝病,死亡率很高. 早期诊断,预后得分如MELD3.0和普雷尼索隆治疗改善了结果,移植是最后的手段.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 酒精相关性肝炎是酒精相关性肝病的最严重形式.
- 严重的病例存在,一个月死亡率为30-50%.
- 诊断主要是临床的,在非典型病例中进行肝脏活检.
研究的目的:
- 概述目前与酒精相关的肝炎的诊断和预后方法.
- 审查这种情况的标准和救援治疗选择.
- 强调支持性护理在控制与酒精有关的肝炎方面的重要性.
主要方法:
- 基于病史和体检的临床诊断.
- 使用末期肝病模型 (MELD) 的预后分层3.0分.
- 从第4天开始使用里尔得分来评估治疗反应.
主要成果:
- 普雷迪尼索隆 (40毫克/天28天) 是符合条件的患者的标准治疗.
- 营养支持和成管理对于生存至关重要.
- 早期的肝移植是对选择的不响应患者的可行的救援选择.
结论:
- 与酒精相关的肝炎需要及时诊断和风险分层.
- 包括医疗治疗,营养支持和成管理在内的多方面的管理是必不可少的.
- 肝移植为精心挑选的患者提供了潜在的生存益处.
相关概念视频
Oxidation of Alcohols
16.2K
In this lesson, the oxidation of alcohols is discussed in depth. The various reagents used for oxidation of primary and secondary alcohols are detailed, and their mechanism of action is provided.
The process of oxidation in a chemical reaction is observed in any of the three forms:
The process of oxidation in a chemical reaction is observed in any of the three forms:
16.2K
Ethers from Alcohols: Alcohol Dehydration and Williamson Ether Synthesis
12.9K
Overview
Ethers can be prepared from organic compounds by various methods. Some of them are discussed below,
Preparation of Ethers by Alcohol Dehydration
In this method, in the presence of protic acids, alcohol dehydrates to produce alkenes and ethers under different conditions. For example, in the presence of sulphuric acid, dehydration of ethanol at 413 K yields ethoxyethane, whereas it yields ethene at 443 K.
Ethers can be prepared from organic compounds by various methods. Some of them are discussed below,
Preparation of Ethers by Alcohol Dehydration
In this method, in the presence of protic acids, alcohol dehydrates to produce alkenes and ethers under different conditions. For example, in the presence of sulphuric acid, dehydration of ethanol at 413 K yields ethoxyethane, whereas it yields ethene at 443 K.
12.9K
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
281
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
281
Protection of Alcohols
8.1K
This lesson delves into the concept of protection and deprotection of a functional group fundamental to synthetic organic chemistry. These phenomena are explained in the context of aliphatic and aromatic alcohols.
Protection
It defines a protecting group as the masking agent to make the more reactive species inert to a given set of conditions. This concept is depicted via the illustration of liquid flow through different outlets in an assembly of pipes. The analogy helps to understand the role...
Protection
It defines a protecting group as the masking agent to make the more reactive species inert to a given set of conditions. This concept is depicted via the illustration of liquid flow through different outlets in an assembly of pipes. The analogy helps to understand the role...
8.1K
Hepatic Portal System
6.0K
The hepatic portal system, a critical part of our circulatory framework, transports nutrient-laden, deoxygenated blood from the gastrointestinal tract and spleen to the liver. This ingenious system plays an indispensable role in maintaining our body's metabolic equilibrium.
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
6.0K
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
247
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
247


