酒精相关性肝病患者酒精使用障碍的治疗

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Seminars in liver disease Pub Date : 2022-03-15 DOI:10.1055/a-1798-2872

C. Tarli, A. Mirijello, G. Addolorato

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引用次数: 4

摘要

酒精使用障碍(AUD)是全球死亡和残疾的主要原因之一。肝脏是酒精损害的主要目标，酒精相关肝病(ALD)是西方国家肝硬化的首要原因。戒酒是AUD合并ALD患者治疗的主要目标，因为持续饮酒对ALD的治疗效果较差。此外，持续饮酒与更高的死亡率、肝移植需求增加和移植物损失有关。AUD最有效的治疗方法是心理社会干预、药物治疗和医疗管理相结合。然而，这些治疗方法对ALD患者的有效性值得怀疑，因为AUD合并ALD的患者通常出于对肝脏安全的考虑而被排除在药理学试验之外。这篇叙述性综述将讨论AUD-ALD患者的治疗选择，重点是药物治疗方面的争议。

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Treating Alcohol Use Disorder in Patients with Alcohol Associated Liver Disease.

Alcohol use disorder (AUD) is one of the main causes of global death and disability. The liver represents the main target of alcohol damage and alcohol associated liver disease (ALD) represents the first cause of liver cirrhosis in Western Countries. Alcohol abstinence is the main goal of treatment in AUD patients with ALD, because treatments for ALD are less effective when drinking continues. Moreover, the persistence of alcohol consumption is associated with higher mortality, increased need for liver transplantation and graft loss. The most effective treatment for AUD is the combination of psychosocial interventions, pharmacological therapy and medical management. However, the effectiveness of these treatments in patients with ALD are doubtful even because AUD patients with ALD are usually excluded from pharmacological trials due to concerns on liver safety. This narrative review will discuss the treatment options for AUD-ALD patients focusing on controversies in pharmacological therapy.

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来源期刊

Seminars in liver disease 医学-胃肠肝病学

CiteScore

8.20

自引率

2.40%

发文量

期刊介绍： Seminars in Liver Disease is a quarterly review journal that publishes issues related to the specialties of hepatology and gastroenterology. As the premiere review journal in the field, Seminars in Liver Disease provides in-depth coverage with articles and issues focusing on topics such as cirrhosis, transplantation, vascular and coagulation disorders, cytokines, hepatitis B & C, Nonalcoholic Steatosis Syndromes (NASH), pediatric liver diseases, hepatic stem cells, porphyrias as well as a myriad of other diseases related to the liver. Attention is also given to the latest developments in drug therapy along with treatment and current management techniques. Seminars in Liver Disease publishes commissioned reviews. Unsolicited reviews of an exceptional nature or original articles presenting remarkable results will be considered, but case reports will not be published.