간경변증 환자에서 심혈관계 자율신경 기능이상

Abstract

Autonomic neuropathy has been reported in association with liver cirrhosis. Cardiovascular autonomic nerve function was tested in fourteen healthy control subjects and twenty-six liver cirrhosis patients. Heart rate response to Valsalva maneuver and to deep breathing, and immediate heart rate response to standing were used to assess parasympathetic function. Blood pressure response to standing and to sustained hand grip were used to assess sympathetic function. Cardiovascular autonomic dysfunction was diagnosed when at least one response of five tests was abnormal. The cirrhosis patients were also subdivided into two groups according to the indocyanine green (ICG) secretion test abnormality (cut off value 15%), and into three groups according to the Child-Pugh classification respectively. One (7%) of fourteen control subjects and fifteen (58%) of twenty-six cirrhosis patients showed evidence of cardiovascular autonomic dysfunction. One (17%) of six patients with normal ICG test, and fourteen (70%) of twenty patients with abnormal ICG test showed abnormal test results. Five (38%) of thirteen patients with Child-Pugh classification A, and ten (77%) of thirteen, patinets with Child-Pugh classification B and C showed cardiovascular autonomic dysfunction. These results show that cardiovascular autonomic dysfunction is, common in the liver cirrhosis patients, and parallels with disease severity.