bmjourБайкальский медицинский журналBaikal Medical Journal2949-0715Irkutsk State Medical University10.57256/2949-0715-2023-2-20-29bmjour-65Research ArticleНаучные обзоры литературыScientific literature reviewsАЛКОГОЛЬНАЯ БОЛЕЗНЬ ПЕЧЕНИ: ВОПРОСЫ ЭТИОЛОГИИ И ВЛИЯНИЕ ФАКТОРОВ РИСКА (ОБЗОР ЛИТЕРАТУРЫ)ALCOHOLIC LIVER DISEASE: ISSUES OF ETIOLOGY AND THE IMPACT OF RISK FACTORS (LITERATURE REVIEW)https://orcid.org/0009-0004-6711-7999СтепаненкоДарья АнатольевнаStepanenkoDaria A.

врач-терапевт, гастроэнтеролог, ассистент кафедры факультетской терапии ФГБОУ ВО ИГМУ Минздрава России

dasha.st.806@mail.ruhttps://orcid.org/0000-0003-3441-3498ГомаТатьяна ВладимировнаGomaTatyana V.

к.м.н., доцент кафедры факультетской терапии ФГБОУ ВО ИГМУ Минздрава России

etikkom@mail.ruhttps://orcid.org/0000-0002-0083-8845КозловаНаталия МихайловнаKozlovaNatalia M.

д.м.н., заведующая кафедрой факультетской терапии, ФГБОУ ВО ИГМУ Минздрава России

natkova@yandex.ruИркутский государственный медицинский университетРоссияIrkutsk State Medical UniversityRussian Federation202310062023222029Copyright © Степаненко Д.А., Гома Т.В., Козлова Н.М., 20232023Степаненко Д.А., Гома Т.В., Козлова Н.М.Stepanenko D.A., Goma T.V., Kozlova N.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bmjour.ru/jour/article/view/65

Употребление алкоголя – это одна из основных причин, приводящих к  хроническим заболеваниям печени. Алкогольная болезнь печени является совокупностью каскадных событий, состоящих  сначала из алкогольного стеатоза печени, а затем, в основном, через алкогольный стеатогепатит, приводящих к циррозу и гепатоцеллюлярной карциноме. В данном обзоре рассматривается хроническая алкогольная интоксикация, как основной фактор развития болезни печени. Представлены современные данные о распространенности форм алкогольного поражения печени в России и в мире. Дана оценка роли употребляемой дозы этанола, характера алкогольного напитка, а также модели потребления алкоголя в формировании повреждения печени, представлены предрасполагающие факторы. Ведущими факторами риска алкогольного поражения печени являются: принадлежность к женскому полу, наследственная предрасположенность (этническая принадлежность), трофологический статус (дефицит массы тела или ожирение), прием некоторых гепатотоксичных препаратов, количество и длительность употребления алкоголя и тип употребляемых спиртных напитков, курение. Также предрасполагают к алкогольному повреждению печени наличие сопутствующего вирусного гепатита, средовое токсико - экологическое влияние и пренатальная интоксикация. В статье дана подробная оценка роли представленных факторов риска в развитии алкогольного поражения печени. Однако выявить доминирующий фактор риска алкогольного поражения печени не представляется возможным, так как развитие патологии печени напрямую зависит не только от количества употребляемого алкоголя, но и от индивидуального сочетания предрасполагающих факторов. Понимание этиологии заболевания и вклада в ее развитие модифицируемых факторов риска позволит разработать эффективные стратегии, направленные на снижение заболеваемости и смертности от болезней печени.

Alcohol consumption is one of the main causes leading to chronic liver disease. Alcoholic liver disease is a set of cascading events, consisting first of alcoholic hepatic steatosis and then mainly through alcoholic steatohepatitis, leading to cirrhosis and hepatocellular carcinoma. This review considers chronic alcohol intoxication as the main factor in the development of liver disease. Modern data on the prevalence of forms of alcoholic liver damage in Russia and in the world are presented. The role of the consumed dose of ethanol, the nature of the alcoholic beverage, as well as the pattern of alcohol consumption in the formation of liver damage is assessed, predisposing factors are presented. The leading risk factors for alcoholic liver damage are: female gender, hereditary predisposition (ethnicity), trophological status (underweight or obesity), taking certain hepatotoxic drugs, the amount and duration of alcohol consumption and the type of alcohol consumed, smoking. The presence of concomitant viral hepatitis, environmental toxico-ecological influence and prenatal intoxication also predispose to alcoholic liver damage. The article provides a detailed assessment of the role of the presented risk factors in the development of alcoholic liver damage. However, it is not possible to identify the dominant risk factor for alcoholic liver damage, since the development of liver pathology directly depends not only on the amount of alcohol consumed, but also on the individual combination of predisposing factors. Understanding the etiology of the disease and the contribution of modifiable risk factors to its development will allow the development of effective strategies aimed at reducing the incidence and mortality from liver diseases.

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The authors declare that there are no conflicts of interest present.