ABSTRACT
Alcoholic liver disease (ALD) is a chronic liver disease in which the internal liver tissues are inflammation damaged caused by long-term excessive drinking. Direct or indirect induction of hepatic inflammatory response by ethanol and its derivatives in the metabolic process may be an important mechanism of ALD, but the underlying cellular and molecular mechanisms of this process are still unclear. Recent study found that interleukin-6 (IL-6) response to ethanol mediated inflammation of the liver cells with dual role. It is involved in an inflammatory process that drives alcohol damage, activate cell apoptosis signaling pathways to stimulate macrophage and lymphocyte acute reactive protein synthesis aggravate the inflammatory response, and can lead to liver cell regeneration, increase anti-inflammatory cytokine levels play anti-inflammatory function to improve the degree of liver injury, and exercise stress can cause muscle source sex IL-6 temporary increased significantly, change the liver oxidation-inflammatory state. Then the body is kept in the adaptive state of long-term anti-inflammation to prevent the inflammatory damage of liver cells. Based on deepening the understanding of ALD inflammation pathological mechanism at the same time, the review on alcoholic liver cell inflammation related factor change and the IL-6 regulation pathway, considering the clinical use of IL-6 joint inflammatory factor pathway of targeted therapy is expected to be a novel therapy, the feasibility for laboratory screening of inflammatory related ALD drug intervention, for the prevention of alcoholic liver disease and treatment to provide new targets and train of thought.
ABSTRACT
Objective To study liver transplantation in the treatment of alcoholic liver disease (ALD).Methods A retrospective study was conducted on 40 patients with ALD who underwent liver transplantation in the Changzheng Hospital of the Second Military Medical University from April 2005 to June 2017.The data were expressed as mean ± standard deviation ((-x) ±s) in populations with a normal distribution,and as median (min～max) in populations with an abnormal distribution.The survival rate was analyzed by life tables,and the Cox regression analysis was used for multivariate analysis.Results All patients were followed up until August 31,2017.The follow-up time was 2 ～ 4518 days,with a median of 997 days.Among the 40 patients,8 had already died (3 died of multiple organ failure,2 of biliary complications,1 of liver failure,1 of sepsis and 1 of recurrence of hepatocellular carcinoma (HCC).The 1-year survival rate was 81.0％,and the 5-year survival rate was 77.0％.Four of 40 patients developed tumor recurrence.The initial recurrence time was 189 ～ 337 days (median 236.5).The recurrence sites included the liver,colon combined with lungs,lungs,and lumbar vertebrae.Six of 40 (15.0％) patients had relapse in alcoholism.Multivariate analysis showed that age was a prognostic factor (RR =1.109,P ＜0.05).Years of drinking,daily amount of alcohol intake,abstinence,a previous history of upper gastrointestinal bleeding,a previous history of splenectomy,co-existing hepatocellular carcinoma,preoperative MELD score,preoperative Child-Pugh score,total operation time,anhepatic period,cold ischemia time,amount of intraoperative bleeding,postoperative alcoholism relapse,tumor recurrence or new onset of tumor were not significantly correlated with the postoperative survival rate (P＞0.05).Conclusions ALD patients were mostly 40 ～ 60 years old.Age was an independent factor affecting survival.The younger the patient,the better the prognosis.Other factors were of no prognostic significance.
ABSTRACT
Objective To approach the clinical effect and safety of glutathione in patients with alcoholic liver disease(ALD).Method The patients were divided into two groups, including the control group and treatment group.Two groups are all treated with routine therapy such as Ganlixin,potassium magnesium aspartate,mulivitamins and so on,the treatment group add glutathione,to inspect clinical menifetation and liver function changes of two groups before and after treatments.Result Among the treatment group,43.6%showed notable effective result,51.3%effective,the total dffective rate is 94.9%. Among the control group, 19.4%showed notable effective result, 58.3%effective,the total dffective rate is 78.7%.There is a significant different between the two groups (P