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慢性肝疾患における自律神経疾患の自然史
M T Hendrickse1, P J Thuluvath, D R Triger
1Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK.
Lancet (London, England)
|June 13, 1992
まとめ
自律神経病,特に神経病は,慢性肝疾患において一般的です. この状態の患者は,著しく高い死亡リスクに直面し,予後におけるその重要性を強調しています.
科学分野:
- 心臓病学 心臓病学
- 肝臓病理学 肝臓病理学
- 神経学 神経学とは
背景:
- 慢性肝疾患 (CLD) は,複数の臓器系に影響を及ぼします.
- 自律的機能障害は,CLLの既知の合併症である.
- CLDにおける自律神経疾患の自然史と予後的意義については,さらなる解明が必要である.
研究 の 目的:
- CLDの患者における自律神経疾患の有病率と自然経歴を将来的に評価する.
- CLD患者における自律神経疾患と死亡率の関連性を評価する.
- このコホートにおける死亡率の予測要因を特定する.
主な方法:
- 肝機能が保たれた60人のCLD患者の見通し評価.
- 標準的な心血管自律機能テストを使用した.
- 病気の進行と逆行性をモニタリングするために,シリアルテストが行われました.
主要な成果:
- 初期検査では,患者の45%に神経病気が認められた.
- 自律的機能不全は,アルコール関連および非アルコール関連肝疾患において同等に一般的であった.
- 静脈神経症の患者の4年死亡率は30%で,静脈神経症の患者では6%であった.
- ヴァガル神経症と肝損傷の重度が独立して死亡率を予測した.
結論:
- 管機能不全は,十分に補償された慢性肝疾患における一般的な発見です.
- 神経病の存在は,より悪い予後を持つ高リスクサブグループを特定します.
- 自律的機能の異常は,CLDにおいて漸進的または可逆的であり得る.
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