Understanding of severe alcoholic hepatitis!
Severe alcoholic hepatitis (SAL), formerly known as the chronic alcoholics with acute liver failure.
Severe alcoholic hepatitis is defined as alcoholic hepatitis, hepatic coma, pneumonia, acute renal failure, upper gastrointestinal bleeding associated with endotoxemia. Although the broken wine continued to liver large, the majority of those in poor prognosis, PTA 50% or less, a significant increase in white blood cells in histology, the majority appear Mai’s body (Mb), can be seen with severe liver cell degeneration and necrosis of and so on.
1987 Abe Hongyan such reports 73 cases of alcoholic hepatitis in 8 patients with severe alcoholic hepatitis cases, of which 4 cases with autopsy pathological data, age 29 to 65 years old, both males, the average amount of alcohol Precision 107 ~ 225g / d, alcohol 10 ~ 30 years, almost all cases, when the House condemns individuals are still drinking, hepatomegaly up to Youlei under 3-8cm, 8 cases 7 cases of ascites (87.5%). 6 cases of disturbance of consciousness (75%). 8 patients, 7 cases were complicated with pneumonia, renal insufficiency, gastrointestinal bleeding and other complications, at the Last 3-38 days after the death of drinking, only 1 case resumed.
Hospital records of 7 cases when the body temperature, there are 4 cases (57.21%) increase in body temperature; eight cases of people’s homes WBC count (11.4 ~ 36.3) * 109 / L, there are four cases of category to see the type of leukemia blast cells showed an increase like reaction. RBC 2.12 ~ 4.06) * 1012 / L was anemic appearance, 7 cases in 5 cases (71.4%) see thrombocytopenia. 7 cases of PAT was 33% ~ 48%, all at 50% or less. Serum total bilirubin in 51.3 ~ 478.8mmol / L. AST / ALT ratio showed high values, serum albumin, cholesterol values of the majority of low serum BUN value of 7 cases in 4 cases (57.1%), creatinine (Cr) 7 3 cases (42.8%) increased significantly. 7 cases of blood amylase increased in 3 cases. Chest X-ray film see the six cases in 6 cases (85.7%) had pneumonia, lung abscess and other abnormalities.
7 died in the four cases of autopsy, see a significant hepatomegaly, histology on 3 cases (75%) sub-chunk necrosis, four cases of all-Mai’s body there, all of the organization was as alcoholic hepatitis, 1 case showed liver cirrhosis, 2 cases of cirrhosis of the liver showed the early stage of no more than one cases of lobular alterations tendencies, all the pathological diagnosis of pneumonia, lung abscess, pulmonary edema, acute renal failure, cellulose pericarditis, acute pancreatitis, where a particular or the number of co-existence.
Severe alcoholic hepatitis deaths in a number of multi-organ damage combined, showing endotoxemia, blood in the high frequency of immune complexes, inflammatory cytokines were significantly higher, showing status of reticuloendothelial system dysfunction.