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Automated frequency analysis of electroencephalogram (EEG) with simultaneous estimation of clinical laboratory tests including plasma amino acids was performed in 29 cases of acute or fulminant hepatitis and 19 cases with cirrhosis of the liver.Higher incidence of slow waves was observed as the severity of hepatic encephalopathy progressed up to the grade III.In acute hepatitis, incidence of slow waves was more significantly related to aromatic amino acids (AAA) level and methionine than branched chain amino acids (BCCA) level.On the contrary, in cirrhosis of the liver, it was more significantly related to BCAA than AAA and methionine.Incidence of slow waves was weakly significantly related to the ratio of BCAA over AAA in acute hepatitis, whereas, in cirrhosis of the liver this correlation was much significant.These results suggest that automated frequency analysis of EEG can be utilized as useful tool in assessing the severity of hepatic encephalopathy.Among the disturbances of amino acid patterns in hepatic encephalopathy, lower BCAA/AAA ratio may indicate the reduction of functional liver mass in cases of acute hepatitis.By contrast, in cirrhosis of the liver this lower ratio appears to play a role in part in the pathogenesis of encephalopathy.
- 財団法人 日本消化器病学会の論文