慢性酒精中毒伴发营养不良和肝功能异常的研究
作者：胡建 冯磊光 邬素萍 徐晔 张磊晶 李哈林
单位：150001 哈尔滨医科大学第一临床医学院精神卫生研究所
关键词：慢性酒精中毒；营养不良；肝功能异常
中国临床营养杂志000102摘 要：目的研究慢性酒精中毒伴发营养不良和肝功能异常的比率和原因。方法对88例慢性酒精中毒患者，调查饮酒史和饮食量，化验肝功能，测定血中前白蛋白(PA)、锌(Zn)和维生素B1(VB1)的含量。结果进餐很少的年数，白蛋白(ALB)和PA异常组多于正常组(P<0.05)。每日饮酒最多次数，进餐很少组多于进餐正常组(P<0.05)。PA、Zn和VB1缺乏程度进餐很少组重于进餐正常组(P<0.05)。每日饮酒量及频率，肝功能异常组多于肝功能正常组(P<0.05)。结论(1)慢性酒精中毒病人因长期大量频繁酗酒和进餐很少而导致营养不良，提示PA和Hb(血红蛋白)可能对反应慢性酒精中毒是否并发营养不良比较敏感。(2)本组88例慢性酒精中毒病人，如果近月每日大量(约390克)而又频繁(约6次)酗酒，就会导致肝功能异常。提示谷氨酰转肽酶(GGT)高低可能是判断慢性酒精中毒是否伴有肝功能异常比较敏感的指标。
, 百拇医药
A Study of the Malnutrition and Liver Dystunction Induced by Chronic Alcoholism
HU Jian ,WU Suping ,FENG Leiguang
(Mental Health Institute, First Teaching Hospital, Harbin Medical University, Harbin 150001)
Abstract：Objective To investigate the comorbidity of chronic alcoholism, malnutrition, and liver dystunction. Then, we research the cause of the nutritional deficiency and liver dystunction induced by chronic alcoholism. Methods There were 88 patients of chronic alcoholism. The drinking history and the intake of food were investigated. A liver function was examined. Prealbumin (PA), Zinc (Zn) and Vitamin B1 (VB1) were measured. Results The years of feeders with little intake of food in the albumin (ALB) & PA abnormal group is more than those in the ALB & PA normal group. The daily frequency of drinking in the group with little intake of food is more than that in the groups with normal intake of food or with diminishing intake of food. As for PA, Zn and VB1, deficiency in the former is more serious than that in the latter. The daily intake of alcohol and the drinking frequency in the group with liver malfunction are greater than those in the group with normal liver function. Conclusions (1) Malnutrition of chronic alcoholic patientsis induced by large consumption of alcohol with small intake of food over a long period of time. The main compositions of malnutrition include ALB, PA, Hb (hemoglobin), Zn and VB1. Among those, PA and Hb may be more sensitive to detecting whether chronic alcoholism is accompanied by malnutrition. (2) The 88 patients of chronic alcoholism, if the daily intake of alcohol is in large quantities and very frequent during the past month, the alcoholic toxicity will aggravate liver damage and liver dystunction. The level of glulsmyl-transpeptidase (GGT) may be a relatively sensitive index for assessing whether chronic alcoholism is accompanied by liver function abnormality.
, 百拇医药
Keywords：Chronic alcoholism Malnutrition Liver dystuntion
参考文献：
[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fourth Edition. Washington, DC, American Psychiatric Association, 1994. 195.
[2]Gilman S, Adams K, Koeppe RA, et al. Cerebellar and frontal hypometabolism in alcoholic cerebeUar degeneration studied with position emission tomography. Ann Neurol, 1990, 28: 775-785.
, 百拇医药
[3]叶应妩，王毓三主编.全国临床检验操作规程.第1版.南京：东南大学出版社，1991，2-4，8，145-148，186-199，218-219.
[4]叶应妩，李健斋，王玉珲主编.临床实验诊断学(上).第1版.北京：人民卫生出版社，1989，372.
[5]于守洋，刘志诚主编.营养与食品卫生监督检验方法指南.第1版.北京：人民卫生出版社，1989，163-166.
[6]Sankaran H, Larkin EC, Rao GA. Induction of malnutrition in chronic alcoholism: role of gastric emptying. Med Hypotheses, 1994, 42: 124-128.
[7]Thuluvath PJ, Triger DR. Evaluation of nutritional status by using anthropometry in adults with alcoholic and nonalcoholic liver disease. Am J Clin Nutr, 1994, 60: 269-273.
, 百拇医药
[8]胡建，沈海今.韦尼克脑病的特征研究.中国危重病急救医学，1998，10：251-253.
[9]Tan GH, FernellGF, Hensrud DD, et al. Acute Wernicke's encephalopathy attributable to pure dietary thiamine deficiency. Mayo Clin Proc, 1994 ,69: 849-850.
[10]Klein S, B. S., R. D., et al. Alcoholism and associated malnutrition in the elderly. Nutrition, 1991, 7: 75-79.
[11]Walton NH, Bowden SC. Does liver dysfunction explain neuropsychological status in recently detoxified alcohol-dependant clients? Alcohol, 1997, 32: 287-295.
收稿日期：1998-09-14
修稿日期：1999-11-03, http://www.100md.com
单位：150001 哈尔滨医科大学第一临床医学院精神卫生研究所
关键词：慢性酒精中毒；营养不良；肝功能异常
中国临床营养杂志000102摘 要：目的研究慢性酒精中毒伴发营养不良和肝功能异常的比率和原因。方法对88例慢性酒精中毒患者，调查饮酒史和饮食量，化验肝功能，测定血中前白蛋白(PA)、锌(Zn)和维生素B1(VB1)的含量。结果进餐很少的年数，白蛋白(ALB)和PA异常组多于正常组(P<0.05)。每日饮酒最多次数，进餐很少组多于进餐正常组(P<0.05)。PA、Zn和VB1缺乏程度进餐很少组重于进餐正常组(P<0.05)。每日饮酒量及频率，肝功能异常组多于肝功能正常组(P<0.05)。结论(1)慢性酒精中毒病人因长期大量频繁酗酒和进餐很少而导致营养不良，提示PA和Hb(血红蛋白)可能对反应慢性酒精中毒是否并发营养不良比较敏感。(2)本组88例慢性酒精中毒病人，如果近月每日大量(约390克)而又频繁(约6次)酗酒，就会导致肝功能异常。提示谷氨酰转肽酶(GGT)高低可能是判断慢性酒精中毒是否伴有肝功能异常比较敏感的指标。
, 百拇医药
A Study of the Malnutrition and Liver Dystunction Induced by Chronic Alcoholism
HU Jian ,WU Suping ,FENG Leiguang
(Mental Health Institute, First Teaching Hospital, Harbin Medical University, Harbin 150001)
Abstract：Objective To investigate the comorbidity of chronic alcoholism, malnutrition, and liver dystunction. Then, we research the cause of the nutritional deficiency and liver dystunction induced by chronic alcoholism. Methods There were 88 patients of chronic alcoholism. The drinking history and the intake of food were investigated. A liver function was examined. Prealbumin (PA), Zinc (Zn) and Vitamin B1 (VB1) were measured. Results The years of feeders with little intake of food in the albumin (ALB) & PA abnormal group is more than those in the ALB & PA normal group. The daily frequency of drinking in the group with little intake of food is more than that in the groups with normal intake of food or with diminishing intake of food. As for PA, Zn and VB1, deficiency in the former is more serious than that in the latter. The daily intake of alcohol and the drinking frequency in the group with liver malfunction are greater than those in the group with normal liver function. Conclusions (1) Malnutrition of chronic alcoholic patientsis induced by large consumption of alcohol with small intake of food over a long period of time. The main compositions of malnutrition include ALB, PA, Hb (hemoglobin), Zn and VB1. Among those, PA and Hb may be more sensitive to detecting whether chronic alcoholism is accompanied by malnutrition. (2) The 88 patients of chronic alcoholism, if the daily intake of alcohol is in large quantities and very frequent during the past month, the alcoholic toxicity will aggravate liver damage and liver dystunction. The level of glulsmyl-transpeptidase (GGT) may be a relatively sensitive index for assessing whether chronic alcoholism is accompanied by liver function abnormality.
, 百拇医药
Keywords：Chronic alcoholism Malnutrition Liver dystuntion
参考文献：
[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fourth Edition. Washington, DC, American Psychiatric Association, 1994. 195.
[2]Gilman S, Adams K, Koeppe RA, et al. Cerebellar and frontal hypometabolism in alcoholic cerebeUar degeneration studied with position emission tomography. Ann Neurol, 1990, 28: 775-785.
, 百拇医药
[3]叶应妩，王毓三主编.全国临床检验操作规程.第1版.南京：东南大学出版社，1991，2-4，8，145-148，186-199，218-219.
[4]叶应妩，李健斋，王玉珲主编.临床实验诊断学(上).第1版.北京：人民卫生出版社，1989，372.
[5]于守洋，刘志诚主编.营养与食品卫生监督检验方法指南.第1版.北京：人民卫生出版社，1989，163-166.
[6]Sankaran H, Larkin EC, Rao GA. Induction of malnutrition in chronic alcoholism: role of gastric emptying. Med Hypotheses, 1994, 42: 124-128.
[7]Thuluvath PJ, Triger DR. Evaluation of nutritional status by using anthropometry in adults with alcoholic and nonalcoholic liver disease. Am J Clin Nutr, 1994, 60: 269-273.
, 百拇医药
[8]胡建，沈海今.韦尼克脑病的特征研究.中国危重病急救医学，1998，10：251-253.
[9]Tan GH, FernellGF, Hensrud DD, et al. Acute Wernicke's encephalopathy attributable to pure dietary thiamine deficiency. Mayo Clin Proc, 1994 ,69: 849-850.
[10]Klein S, B. S., R. D., et al. Alcoholism and associated malnutrition in the elderly. Nutrition, 1991, 7: 75-79.
[11]Walton NH, Bowden SC. Does liver dysfunction explain neuropsychological status in recently detoxified alcohol-dependant clients? Alcohol, 1997, 32: 287-295.
收稿日期：1998-09-14
修稿日期：1999-11-03, http://www.100md.com