摘要
Thirty-three cases with histologically proven alcoholic liver disease (ALD) were analysed retrospectively in Taipei Municipal Jen-Ai Hospital from March 1978 to June 1984. All but one patient were male with ages ranged from 26 to 69 years and average 43.1 years. The predominant alcoholic beverage was rice-wine(70%). The average daily alcohol consumption was 160 gm. Patients were divided into two groups, for those who consumed alcohol more than 120gm/day and persisted longer than 15 years as group A, otherwise group B. The results revealed that 14 out 21 patients in group A developed cirrhosis, in contrast to only one out of 12 patients in group B. The difference was statistically significant, P=0.016. Clinically, the most common presentation of the patients was ill-defined gastrointestinal symptoms such as abdominal fullness, abdominal pain, nausea, vomiting, diarrhea and anorexia etc. (61%). Hepatomegaly was the main physical sign (73%). Laboratory data showed a larger MCV, a higher SGOT/SGPT and γ-GT/ALK-P ratio in comparison with the non-ALD (P＜0.05). In addition, uric acid and serum IgA levels also appeared higher than normal range but not significant statistically. Serum HBsAg was positive in 18% of cases, By using immunoalkal-inphosphatase (APAAP) technique, the patterns of IgA deposition in liver tissue were different from those of non-ALD. Abdominal ultrasound was found to be a good screening tool in detecting fatty liver, peritoneoscopy was a good adjunct and liver biopsy remained the diagnostic procedure. Histologically, the most frequent finding was fatty metamorphosis (88%). Mallory bodies were found in only three (9%) cases and alcoholic cirrhosis was developed 15%(45%)cases. Five cases were deceased in which four died of massive esophageal varices bleeding and one from hepatic coma, the mortality rate being 15%. The study showed that though viral hepatitis is so prevalent in this area, nevertheless, ALD is still need to be concerned.