Kempler P, Szalay F, Váradi A, Hermányi Z, Marton A, Fazekas K
I. Belgyógyászati Klinika, Semmelweis Orvostudományi Egyetem, Budapest.
Orv Hetil. 1993 Apr 18;134(16):853-7.
Autonomic neuropathy has been evaluated by various cardiovascular bedside tests in 172 patients with chronic alcoholism (36 alcoholics without liver disease, 50 patients with fatty liver and 86 with cirrhosis), in 21 patients with HBsAg-positive chronic liver disease, in 14 patients with primary biliary cirrhosis, in 14 patients with cirrhosis of other origin and in 86 healthy controls. Parasympathetic integrity was evaluated by beat-to-beat variation during deep breathing, Valsalva manoeuvre and standing up, sympathetic function by blood pressure response to standing and to sustained handgrip test. Autonomic reflex damage was found in all groups examined. Patients with alcoholic cirrhosis exhibited the most severe alterations. Our results suggest, that chronic hepatopathy itself presents a pathogenetic factor of autonomic neuropathy. Autonomic failure has to be considered as a possible cause of symptoms in liver diseases with all its prognostic consequences.
对172例慢性酒精中毒患者（36例无肝脏疾病的酗酒者、50例脂肪肝患者和86例肝硬化患者）、21例HBsAg阳性慢性肝病患者、14例原发性胆汁性肝硬化患者、14例其他原因引起的肝硬化患者以及86例健康对照者，通过各种心血管床边检查评估自主神经病变。通过深呼吸、瓦尔萨尔瓦动作和站立时的逐搏变化评估副交感神经完整性，通过站立和持续握力试验时的血压反应评估交感神经功能。在所有检查的组中均发现自主神经反射损害。酒精性肝硬化患者表现出最严重的改变。我们的结果表明，慢性肝病本身是自主神经病变的一个致病因素。自主神经功能衰竭必须被视为肝病症状的一个可能原因及其所有预后后果。
