알코올과 간질환

Alcohol and Liver disease

  • 박병채 (고신대학교 의학부 내과학교실)
  • 발행 : 1995.08.01

초록

Alcoholic liver disease is defined by the development of three types of liver damage following chronic heavy alcohol consumption, namely, alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis, The clinical features and laboratory tests often do not distinguish among these types of liver injuries. In addition, a considerable number of the patients who have clinical and laboratory features compatible with alcoholic liver disease are diagnosed on liver biopsy to have chronic viral hepatitis or other lesion. Because of these factors, liver biopsy is frequently needed to arrive a definite diagnosis of the disease, its activity, and its chronicity. Fatty liver is usually a benign and reverible condition that disappears on abstinence from alcohol. However, alcoholic hepatitis is usually regarded as a precursor of cirrhosis. The principle factors in the development of alcoholic hepatitis and cirrhosis are the quantity and length of ingestion of alcohol. women are much more susceptible than men to hepatic injuries. Since only 10 - 20% of alcoholics develop cirrhosis, however, it is conceivable that other factors, either genetic, environmental, or nutritional may contribute in the genesis of liver injuries. The most important factor in the treatment of alcoholic liver disease is prolonzed abstinence from alcohol, since abstinence by itself improves clinical status and survival, Nutritional support in patients with nutritional deficiency, and specific drug therapies such as corticosteroid or anabolic steroids for hospitaliged patients with severe alcoholic hepatitis also play an important role in devreasing morbidity and improving survival. Liver transplantation is a newer treatment modality in the patients with advanced cirrhosis, not responsible to medical treatment.

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