关键词： ALD, alcoholic liver disease AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid AUD, alcohol use disorder AUDIT – C, Alcohol Use Disorder Identification Test – Consumption AUDIT, Alcohol Use Disorder Identification Test AWS, alcohol withdrawal syndrome CIWA – Ar, Clinical Institute Withdrawal Assessment for Alcohol Revised CNS, central nervous system EtG, ethyl glucuronide EtS, ethyl sulphate GABA, gamma-aminobutyric acid GGT, gamma glutamyl transferase HE, hepatic encephalopathy MCV, mean corpuscular volume NMDA, N-methyl-d-aspartate alcohol alcoholic liver disease assessment treatment withdrawal

来  源：   DOI：10.1016/j.jceh.2022.03.003   PDF(Pubmed)

Abstract：
Alcohol withdrawal syndrome (AWS) is a common condition that is seen in treatment-seeking patients with Alcohol use disorder (AUD) and alcoholic liver disease (ALD). AWS, which typically starts within 4-6 h of the last alcohol use, can range from mild symptoms such as insomnia, tremors, and autonomic hyperactivity to more severe symptoms such as seizures and delirium tremens. Clinical Institute Withdrawal Assessment Scale-Alcohol Revised (CIWA-Ar) is the most commonly used scale to assess AWS in clinical practice. The presence of moderate withdrawal as indicated by a score of more than 8 is an indication for pharmacotherapy. Lorazepam and oxazepam are preferred agents for the management of AWS in the setting of ALD. In severe ALD, benzodiazepines should be used cautiously with monitoring due to the risk of excessive sedation or precipitating hepatic encephalopathy.
摘要：
酒精戒断综合征（AWS）是一种常见病，见于酒精使用障碍（AUD）和酒精性肝病（ALD）的寻求治疗的患者。AWS,通常在最后一次使用酒精的4-6小时内开始，可以从轻微的症状，如失眠，震颤,和自主神经多动，更严重的症状，如癫痫发作和震颤谵妄。临床研究所戒断评估量表-酒精修订（CIWA-Ar）是临床实践中评估AWS最常用的量表。超过8分的中度戒断的存在是药物治疗的指征。劳拉西泮和奥沙西泮是ALD环境中AWS管理的首选药物。在严重的ALD中，由于存在过度镇静或诱发肝性脑病的风险，因此在监测时应谨慎使用苯二氮卓类药物。
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