PDF(Pubmed)
Abstract：
Alcohol-related liver disease (ALD) represents one of the leading causes of chronic liver disease and is a major cause of liver-related deaths worldwide. ALD encompasses a range of disorders including simple steatosis, alcoholic steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Patients with underlying ALD and continued heavy alcohol consumption can also develop an episode of acute-on-chronic liver injury called alcohol-associated hepatitis, the most severe form of the disease, which portends a poor prognosis. The most important risk factor for the development of ALD is the amount of alcohol consumed. Individual susceptibility to progression to advanced fibrosis among heavy drinkers is likely determined by a combination of behavioral, environmental, genetic, and epigenetic factors, but the mechanisms are largely unknown. The only effective therapy for ALD is prolonged alcohol abstinence. Diagnosis of ALD involves assessing patients for alcohol use disorder and signs of advanced liver disease. In clinical practice, the histological assessment for ALD diagnosis is uncommon, and it is usually based on the medical history, clinical manifestations, and laboratory and imaging tests. Several promising biomarkers that can have both diagnostic and prognostic value in patients with ALD have been identified in recent years. This review provides an overview of the clinical spectrum of ALD, the diagnostic approach of the disease from different perspectives as well as current diagnostic and prognostic biomarkers.
摘要：
酒精相关性肝病（ALD）是慢性肝病的主要原因之一，也是全球肝脏相关死亡的主要原因。ALD包括一系列疾病，包括单纯性脂肪变性，酒精性脂肪性肝炎,纤维化，肝硬化,和肝细胞癌。患有基础ALD和持续大量饮酒的患者也可以发展为急性慢性肝损伤，称为酒精相关肝炎，这种疾病最严重的形式，这预示着预后不良。发展ALD的最重要的风险因素是消耗的酒精量。重度饮酒者个体对进展为晚期纤维化的易感性可能是由行为，环境,遗传,和表观遗传因素，但机制在很大程度上是未知的。ALD的唯一有效疗法是延长酒精禁欲。ALD的诊断涉及评估患者的酒精使用障碍和晚期肝病的体征。在临床实践中,ALD诊断的组织学评估并不常见，通常是根据病史，临床表现，以及实验室和成像测试。近年来，已经确定了几种对ALD患者具有诊断和预后价值的有希望的生物标志物。这篇综述概述了ALD的临床谱，从不同角度对该疾病的诊断方法以及当前的诊断和预后生物标志物。
