Alcoholic hepatitis 2010:A clinician's guide to diagnosis and therapy

作     者：Maziyar Amini Bruce A Runyon 

作者机构：Department of Gastroenterology and HepatologyLoma Linda University Medical Center 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2010年第16卷第39期

页      面：4905-4912页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Alcoholic hepatitis Alcoholic liver disease Pentoxifylline Baclofen 

摘      要：Alcoholic hepatitis(AH)remains a common and life threatening cause of liver failure,especially when it is *** the adjectiveacuteis frequently used to describe this form of liver injury,it is usually subacute and has been developing for weeks to months before it becomes clinically *** with this form of alcoholic liver disease usually have a history of drinking heavily for many *** certain aspects of therapy,mainly nutritional support and abstinence are well established,significant debate has surrounded the pharmacologic treatment of AH,and many institutions practice widely varying treatment protocols. In recent years a significant amount of literature has helped focus on the details of treatment,and more data have accumulated regarding risks and benefits of pharmacologic *** particular,the efficacy of pentoxifylline has become increasingly apparent,and when compared with the risks associated with prednisolone,has brought this drug to the forefront of therapy for severe *** review will focus on the clinical and laboratory diagnosis and pharmacologic therapies that should be applied during hospitalization and continued into outpatient *** conclude that the routine use of glucocorticoids for severe AH poses significant risk with equivocal benefit,and that pentoxifylline is a better,safer and cheaper *** the full details of nutritional support lie beyond the scope of this article,nutrition is a cornerstone of therapy and must be addressed in every patient diagnosed with AH. Finally,while traditional psychosocial techniques play a major role in post-hospitalization care of alcoholics, we hope to make the medical clinician realize his or her role in reducing recidivism rates with early and frequent outpatient visits and with the use of baclofen to reduce alcohol craving.