July 28 is the World Hepatitis Day. The theme of this year is "Understanding Hepatitis, Act Now". China has always been a major country with severe liver diseases, especially hepatitis B. However, with the improvement of the level of domestic medicine, the popularization of disease education, the advent of nucleoside antiviral drugs, and the widespread inoculation of hepatitis B vaccine, new hepatitis B has decreased year by year. Hepatitis B patients have been well controlled. At the same time, the incidence of alcoholic liver and fatty liver has increased dramatically. Here we talk about alcohol liver protection and treatment.
A few days ago, at the expert salon event “Alcohol Injury Prevention and Treatment in Shanghai†held in Shanghai, Dr. Mao Yimin, director of the Department of Gastroenterology at Renji Hospital, Shanghai Jiao Tong University School of Medicine, and deputy director of Shanghai Fatty Liver Diseases Research and Treatment Research Center, on alcoholic liver injury. On the topic of discussion.
According to Professor Mao Yimin, “Compared to viral hepatitis, the attendance rate of alcoholic liver disease is lower. The main reason is that people don’t know enough about alcohol-induced liver injury.†According to him, about 10% to 20% of alcoholic hepatitis patients every year Progress to cirrhosis, if not abstinence and take effective interventions, eventually 70% of patients with alcoholic hepatitis will have the risk of progression to cirrhosis. Severe alcoholic hepatitis and cirrhosis can lead to decompensation of liver function and increase the risk of death. People should pay high attention to alcohol-induced liver injury.
50% of the population "extractive enzymes" lack Chinese people more vulnerable to alcohol injury liver
"Ethanol enters the human body and needs to be metabolized by the alcohol dehydrogenase and acetaldehyde dehydrogenase in the liver. These two enzymes can be described as 'alcohol-metabolizing enzymes' in the human body, but more than half of the Chinese population have alcohol-metabolizing enzymes. Defects or lack of activity.†Professor Mao Yimin said in the event that the deficiency of alcohol metabolism enzymes will directly lead to the slow metabolism of ethanol to acetaldehyde, acetaldehyde to acetic acid, and seriously affect liver health. Therefore, alcohol is more harmful to the Chinese people's liver.
According to Professor Mao, the liver's ability to process alcohol every day is about 180g/24 hours, with an average of 7.5g of alcohol per hour (equivalent to 50° of liquor, less than half of them). Studies show that long-term heavy drinking lasts for more than 5 years. If the amount of alcohol intake exceeds 40g per day for men and women exceed 20g per day, the risk of alcoholic liver disease will increase significantly; within a short period of time, binge drinking will occur within 2 weeks. A large amount of alcohol intake, daily intake of ethanol is more than 80g, or heavy drinking in the short term (more than 3 days), and alcohol intake of 200g or more can cause acute alcoholic hepatitis. Severe patients may have clinical symptoms. Gastrointestinal bleeding, ascites, and even acute alcoholism cause death.
In addition, Prof. Mao also shared the conversion method of alcohol intake during the event: the amount of ethanol (g) = alcohol consumption (mL) × ethanol content (%) × 0.8, that is, the wine containing 40g of ethanol is approximately 333ml of wine, 1250ml Beer, 125ml of 40 degree spirits or 100ml of 50 degree spirits. He emphasized that the ability of alcohol metabolism has a very large correlation with heredity. There is no unified and relatively safe drinking area in the population. Drinking should be done with the right amount of energy.
Women, fat people, and chronic liver patients are "susceptible people"
"Women, fat people, and chronic liver patients are more vulnerable to alcohol than other people, especially if they need to avoid alcohol," Professor Mao said. According to research, estrogen can accelerate oxidative stress and inflammation in the liver, and estrogen is higher in women. Therefore, women are more sensitive to the hepatotoxicity of alcohol. In the same amount of alcohol, women's blood alcohol levels are also higher than men's. , more prone to liver disease.
“The earliest knowledge of the fatty liver in the medical community is also derived from alcohol, because alcohol causes fatty changes in liver cells.†Professor Mao said that 75% of fat people have fatty liver, and fat-modified liver cells cannot only be normal. Metabolic function, can also produce a large number of cytokines to promote inflammation, fat people such as drinking at the same time, and the superposition of both factors of alcohol, not only will increase fatty liver, but also accelerate inflammation, liver fibrosis and even cirrhosis and liver cancer .
The liver of patients with chronic liver disease is itself in a damaged state, which also affects the metabolism of alcohol. After drinking alcohol, ethanol and its metabolite acetaldehyde will accelerate the degeneration and necrosis of hepatocytes and aggravate liver damage. For patients with viral hepatitis, drinking is not a superposition factor, which will increase liver damage and affect human immune function. Reduce the effectiveness of antiviral treatment. Therefore, it seems that drinking alcohol in patients with chronic liver disease is worse.
Prevention of alcoholic liver, drug intervention is more effective
"Alcoholic liver injury, the first prevention is to start from the source - alcohol!" Prof. Mao repeatedly stressed in the activities, alcohol direct damage to the liver, is the first step in alcohol injury liver, only alcohol, can be more Good control of the cause. However, in China, the history of wine culture has a long history. For most people, drinking and socializing need to be difficult to avoid. In this regard, experts suggest that drinking to avoid an empty stomach, drink some oily foods or milk before drinking; appropriate intake of fat when drinking can slow the absorption rate of alcohol, eat lean meat can promote alcohol metabolism; avoid mixing different types of wine to drink, also Do not drink alcohol and carbonated beverages together.
Secondly, for susceptible people who cannot avoid alcohol and “alcoholic liver injuryâ€, drug interventions can be used if necessary. According to China's Guide to Diagnosis and Treatment of Alcoholic Liver Diseases, metadoxine can accelerate the elimination of alcohol from serum and help to improve symptoms and behavioural abnormalities of alcoholism. Prof. Mao introduced in the activity that the clinical application of Ganzi (Mitazepam Tablets) can accelerate the elimination of ethanol and acetaldehyde by activating aldehyde dehydrogenase, and effectively relieve alcohol; at the same time, it can also prevent the metabolism of ethanol and acetaldehyde. Glutathione depletion and increased lipid peroxidation stabilize liver glutathione levels and protect liver cells.
Professor Mao said that in the selection of alcoholic liver treatment drugs should focus on the three points of safety, high efficiency and rapid, in the course of treatment should follow the recommendations of doctors and experts to take drugs, avoid using drugs on the market to protect the liver and protect the liver; life, Should develop healthy drinking methods and reduce "alcoholic liver injury".
The so-called veterinary drugs, referred to as veterinary drugs, refer to drugs that can regulate the function of livestock from the body and prevent and cure livestock and poultry diseases. Natural plants, animals, minerals, and synthetic drugs and immunizations can all be used as veterinary drugs. Feed additives used in animal production are also often included in the category of veterinary medicines
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