肝硬変症の予後並びに糖代謝異常に対する血中norepinephrineの関与

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Plasma levels of norepinephrine (NE), oral glucose tolerance test (OGTT), together with the response of immunoreactive insulin (IRI), were studied in 26 patients with liver cirrhosis. In assessing the plasma NE, 9 patients had normal levels (Group I), and 17 (65.4%) were to be elevated, in which 5 cases progressed into liver cell carcinoma (Group II), 8 died of hepatic failure (Group III), and 4 remained unchanged (Group IV) of 21 months' their clinical course. OGTT disclosed typical diabetic pattern in all patients found to have high levels contrast with the "borderline" pattern in Group I. This represents that plasma concentrations of NE play a large role on the deranged carbohydrate metabolism in liver cirrhosis.On the other hand, the mode of response of IRI were divided into 3 patterns: normal responded type was seen in Group I, poorly responded was shown in Group II and in some patients of Group III, whereas hyperreactive type was seen in Group IV and in some cases of Group III.In view of these studies it seems reasonable to consider that elevated values of plasma NE in liver cirrhosis may be indicating as an exaggerated autonomic nervous system, which in turn produces vasoconstriction with concomitant circulatory disorders of splanchnic vessels.
財団法人日本消化器病学会の論文