Dillon J F, Plevris J N, Nolan J, Ewing D J, Neilson J M, Bouchier I A, Hayes P C
Department of Medicine, Royal Infirmary, Edinburgh, Scotland.
Am J Gastroenterol. 1994 Sep;89(9):1544-7.
To assess the prevalence of autonomic dysfunction in cirrhosis and to observe the effect of disease severity on autonomic dysfunction.
Seventy patients with cirrhosis (Child's class A, 42; Child's class B, 10; and Child's class C, 15) (45 alcoholic, 15 primary biliary cirrhosis, five chronic active hepatitis, and eight idiopathic) underwent standard cardiovascular reflex tests. In addition, in 40 patients, 24-h ECG RR variability tests were performed to detect autonomic dysfunction.
Forty-two of 70 (60%) patients had abnormalities of cardiovascular reflex function of varying severity, whereas 24 of 34 (70%) had 24-h RR counts with the 95% age-related tolerance. The prevalence of abnormality increased with increasing severity of liver disease but not with different etiologies.
Irrespective of etiology, there is a high prevalence of autonomic dysfunction in cirrhosis, and it is related to disease severity: the mechanism is unknown.
评估肝硬化患者自主神经功能障碍的患病率,并观察疾病严重程度对自主神经功能障碍的影响。
70例肝硬化患者(Child A级42例、Child B级10例、Child C级15例)(酒精性肝硬化45例、原发性胆汁性肝硬化15例、慢性活动性肝炎5例、特发性肝硬化8例)接受了标准心血管反射测试。此外,对40例患者进行了24小时心电图RR间期变异性测试以检测自主神经功能障碍。
70例患者中有42例(60%)存在不同程度的心血管反射功能异常,而34例中有24例(70%)的24小时RR间期计数在95%年龄相关耐受范围内。异常患病率随肝病严重程度增加而升高,但与不同病因无关。
无论病因如何,肝硬化患者自主神经功能障碍的患病率都很高,且与疾病严重程度相关:其机制尚不清楚。