Department of Internal Medicine, Trakya University, Medical Faculty, Edirne, Turkey.
Department of Internal Medicine, Trakya University, Medical Faculty, Edirne, Turkey.
Arab J Gastroenterol. 2020 Mar;21(1):32-36. doi: 10.1016/j.ajg.2020.01.003. Epub 2020 Feb 19.
Cirrhosis is a multisystem disorder characterized by hyperdynamic circulation which can progress to multiple organ dysfunctions. Recent studies have demonstrated autonomic dysfunction and cirrhotic cardiomyopathy including diastolic dysfunction, systolic dysfunction with electrophysiologic abnormalities in patients with cirrhosis. Due to the long and complicated course of the disease, health related quality of life is affected. We aimed to evaluate the frequency of diastolic dysfunction and autonomic dysfunction in cirrhosis, and the effects on health-related quality of life.
Hundred cirrhotic patients were enrolled in the study. According to the Child-Pugh classification 35 patients were of Child A, 36 of Child B and 29 of Child C. The proportion of autonomic dysfunction was 52%, and diastolic dysfunction 51%. Autonomic dysfunction was diagnosed using bedside maneuvers and tests; diastolic dysfunction was diagnosed using the E/A ratio in echocardiographic findings. Health-related quality of life measurements was obtained from an SF-36 questionnaire.
Patients with advanced Child-Pugh classifications were found to have significantly lower health-related quality of life values (p < 0.05). Likewise, health-related quality of life values were observed to be significantly lower in patients with autonomic dysfunction (p < 0.05). No significant difference was found in health related quality of life measurements between patients with and without diastolic dysfunction.
Our study showed that autonomic dysfunction and diastolic dysfunction are found in patients with cirrhosis. Further studies are needed to assess the effects of autonomic dysfunction and diastolic dysfunction on health-related quality of life.
肝硬化是一种多系统疾病，其特征为高动力循环，可进展为多器官功能障碍。最近的研究表明，肝硬化患者存在自主神经功能障碍和肝硬化心肌病，包括舒张功能障碍、收缩功能障碍伴电生理异常。由于疾病的病程长且复杂，健康相关生活质量受到影响。我们旨在评估肝硬化患者舒张功能障碍和自主神经功能障碍的发生率，并评估其对健康相关生活质量的影响。
本研究纳入了 100 例肝硬化患者。根据 Child-Pugh 分级，35 例患者为 Child A，36 例为 Child B，29 例为 Child C。自主神经功能障碍的比例为 52%，舒张功能障碍为 51%。自主神经功能障碍通过床边操作和测试进行诊断；舒张功能障碍通过超声心动图的 E/A 比值进行诊断。健康相关生活质量的测量来自 SF-36 问卷。
发现高级 Child-Pugh 分级的患者健康相关生活质量值显著降低（p<0.05）。同样，自主神经功能障碍患者的健康相关生活质量值也明显较低（p<0.05）。舒张功能障碍患者与无舒张功能障碍患者的健康相关生活质量测量值无显著差异。
我们的研究表明，肝硬化患者存在自主神经功能障碍和舒张功能障碍。需要进一步研究来评估自主神经功能障碍和舒张功能障碍对健康相关生活质量的影响。
