酒精使用障碍和酒精相关肝脏疾病:新定义、筛查和治疗

Q2 Medicine
Gastroenterology and Hepatology Pub Date : 2024-11-01
Giovanni A Roldan, Christopher Tricarico, Robert S Brown
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引用次数: 0

摘要

酒精相关性肝病(ALD)造成了重大的全球健康负担,是肝脏相关发病率和死亡率的主要原因。ALD包括一系列疾病状态,从无症状脂肪变性到急性肝炎和肝硬化。酒精使用障碍(AUD)显著增加ALD发生的风险,深入了解AUD可以更全面地了解ALD以及受这些相关疾病影响的患者。即使在初级保健中,通过有效的筛查工具结合血液检查和成像技术,也能准确及时地识别AUD,有助于ALD的早期发现。尽管肝移植(LT)仍然是终末期ALD最有效的治疗方法,但由于对ALD移植资格的看法转变、全面的LT前评估以及LT后ALD检测的进步,患者移植后的结果已经发生了变化。尽管如此,解决ALD的LT实践差异对于确保公平获得这种挽救生命的干预措施至关重要。本文提供了ALD定义、筛选方法和当代管理方法的最新摘要,特别是在LT的背景下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Alcohol Use Disorder and Alcohol-Associated Liver Disease: New Definitions, Screening, and Treatment.

Alcohol-associated liver disease (ALD) poses a significant global health burden and is a leading cause of liver-related morbidity and mortality. ALD encompasses a spectrum of disease states ranging from asymptomatic steatosis to acute hepatitis and cirrhosis. Alcohol use disorder (AUD) significantly increases the risk of developing ALD, and insight into AUD can provide a more complete understanding of ALD and the patients affected by these interrelated diseases. Accurate and timely identification of AUD, even in primary care, through validated screening tools combined with blood tests and imaging techniques facilitates early detection of ALD. Although liver transplantation (LT) remains the most effective treatment for end-stage ALD, patient outcomes post-LT have evolved because of shifting perspectives on ALD transplant eligibility, comprehensive pre-LT evaluations, and advancements in post-LT ALD detection. Nonetheless, addressing disparities in LT practices for ALD is paramount for ensuring equitable access to this life-saving intervention. This article offers an updated synopsis of ALD definitions, screening methodologies, and contemporary management approaches, particularly in the context of LT.

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来源期刊
Gastroenterology and Hepatology
Gastroenterology and Hepatology Medicine-Gastroenterology
CiteScore
3.20
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