嗜酒者的肝脏疾病和肝细胞癌：抗瘾药物的治疗作用

Title:Liver Disease and Hepatocellular Carcinoma in Alcoholics: The Role of Anticraving Therapy

Volume: 17 Issue: 2

Author(s): Paolo Borro, Silvia Leone and Gianni Testino

Affiliation:

关键词: 酒精依赖，酒精性肝病，抗瘾药物、支持小组。

摘要: Alcohol is the main risk factor for death and disability. The treatment of alcohol dependence (AD) is a complex activity as the variables are numerous; however, those which must necessarily be taken into account are the type of AD, the internal comorbidities and the presence of any psychiatric comorbidity. Liver problems are one of the most common causes of alcohol-related liver damage. 45% of deaths from cirrhosis are alcohol-related. Thus, the treatment of AD must often deal with a more or less severe liver disease, which influences the choice of anticraving drug. As chronic liver disease is often present, and as in a substantial proportion of cases, because there is a correlation with viral infections or with hepatocellular carcinoma (HCC), it is clear that hepatologists should make use of nonhepatotoxic molecules. In cases of mild liver disease, all available drugs might be used, but we recommend caution because the liver is usually fragile due to the harmful abuse of alcohol. In the advanced liver disease, the choice of treatment is reduced. A psychosocial approach such as attending support groups could be the first choice. In cases of compensated cirrhosis with or without HCC, or in cases of HCC without cirrhosis, metadoxine, acamprosate and baclofen can be used. In decompensated forms the only drug tested to date has been baclofen. In alcohol-related liver disease a professional team with hepato-alcohologists is also necessary, especially for liver transplantation programs.

Cite this article as:

Paolo Borro, Silvia Leone and Gianni Testino , Liver Disease and Hepatocellular Carcinoma in Alcoholics: The Role of Anticraving Therapy, Current Drug Targets 2016; 17 (2) . https://dx.doi.org/10.2174/1389450116666150518102204