NATURAL-HISTORY OF AUTONOMIC NEUROPATHY IN CHRONIC LIVER-DISEASE
NATURAL-HISTORY OF AUTONOMIC NEUROPATHY IN CHRONIC LIVER-DISEASE
复制标题
DOI：
10.1016/0140-6736(92)92042-e
复制
发表时间：
1992-06-13
期刊：
影响因子：
168.9
通讯作者：
TRIGER, DR
中科院分区：
文献类型：
--
作者：
HENDRICKSE, MT;THULUVATH, PJ;TRIGER, DR
为了确定慢性肝病患者自主神经病变的自然病史，我们使用标准的心血管自主神经测试对60名最初肝功能保存良好的患者(男33名，女27名)进行前瞻性评估。在最初的测试中，27名患者(45%，中位年龄56[32-67]岁)有迷走神经病变。自主神经功能障碍在酒精相关和非酒精相关肝病患者中同样常见。迷走神经病患者的4年累计死亡率为30%，而自主神经功能正常的患者为6%。多因素Logistic回归分析显示，迷走神经病变和肝脏损害的严重程度是死亡率的独立预测因素。系列测试显示，虽然疾病进展发生在一些患者中，但在另一些患者中，自主神经功能的轻度异常是可逆的。功能障碍在代偿良好的慢性肝病中很常见，它的存在识别了一组前景相当糟糕的患者。
To determine the natural history of autonomic neuropathy in chronic liver disease we used standard cardiovascular autonomic tests to evaluate prospectively 60 patients (33 male, 27 female) with initially well-preserved hepatic function.On initial testing, 27 patients (45%, median [range] age 56 [32-67] years) had vagal neuropathy. Autonomic dysfunction was equally common in patients with alcohol-related and non-alcoholic-related liver disease. The cumulative 4-year mortality rate in patients with vagal neuropathy was 30% compared with 6% in those with normal autonomic function. Multiple logistic regression analysis showed that presence of vagal neuropathy and severity of hepatic damage were independent predictors of mortality. Serial testing showed that whereas disease progression occurred in some patients, in others mild abnormalities in autonomic function were reversible.Vagal dysfunction is common in well-compensated chronic liver disease and its presence identifies a subgroup of patients with a substantially worse outlook.