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1Non-invasive diagnosis of alcoholic liver disease显示文摘Alcoholic liver disease(ALD)is the most common liver disease in the Western world.For many reasons,it isunderestimated and underdiagnosed.An early diagnosis is absolutely essential since it(1)helps to identify patients at genetic risk for ALD;(2)can trigger efficient abstinence namely in non-addicted patients;and(3)initiate screening programs to prevent life-threateningcomplications such as bleeding from varices,spontaneous bacterial peritonitis or hepatocellular cancer.The two major end points of ALD are alcoholic liver cirrhosis and the rare and clinically-defined alcoholic hepatitis(AH).The prediction and early diagnosis of both entities is still insufficiently solved and usually relies on acombination of laboratory,clinical and imaging findings.It is not widely conceived that conventional screeningtools for ALD such as ultrasound imaging or routine laboratory testing can easily overlook ca.40%of manifest alcoholic liver cirrhosis.Non-invasive methods such as transient elastography(Fibroscan),acoustic radiation force impulse imaging or shear wave elastography have significantly improved the early diagnosis of alcoholiccirrhosis.Present algorithms allow either the exclusion or the exact definition of advanced fibrosis stages in ca.95%of patients.The correct interpretation of liver stiffness requires a timely abdominal ultrasound and actual transaminase levels.Other non-invasive methods such as controlled attenuation parameter,serum levels of M30 or M65,susceptometry or breath tests are under current evaluation to assess the degree of steatosis,apoptosis and iron overload in these patients.Liver biopsy still remains an important option to rule out comorbidities and to confirm the prognosis namely for patients with AH.Sebastian Mueller Helmut Karl Seitz Vanessa Rausch 2014World Journal of Gastroenterology2014,20,40:15
2细胞色素P4502E1与乙醇代谢相关的肝损伤研究进展显示文摘近年细胞色素P450酶系中的2E1亚家族与乙醇相关的肝损伤研究结果进一步验证了CYP2E1酶在乙醇代谢中的关键作用。CYP2E1酶的多态性对乙醇导致肝损伤的影响包含该酶的代谢效率差异(C2/C2)>(C1/C2)>(C1/C1)造成不同程度的肝脏细胞损伤以及不同等位基因造成饮酒倾向的差异越来越受到关注。研究证实,多种物质尤其是中药材饮片及提取物可影响该酶含量及活性,从而保护肝细胞以及对乙醇损伤后肝脏细胞的修复。本文就近年来细胞色素P4502E1及其基因与乙醇相关的肝损伤研究进展做一综述。张文宇 马满玲 2016西部医学2016,28,11:4
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