:SYMPATHETIC DISORDER AND MICROCIRCULATORY FAILURE

概要

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Plasma concentrations of catecholamine were studied in 56 patients with liver cirrhosis. Epinephrine concentrations remained within normal range in all subjects examined, whereas norepinephrine levels (NE) were normal in 23 patients (41%) and were elevated in 33 (59%). Oral glucose tolerance tests disclosed "borderline" type in the normal NE group (I) and "diabetic" type in the elevated NE group (II). The typical picture of the group I showed neither pleural effusion nor liver atrophy with peripheral platelet count of more than 100, 000/cmm. Peptic ulcer and/or erosions as well as liver atrophy were significantly higher in the subjects with group II than in those with group I, and the platelet count was usually below 100, 000/cmm in group II. On the other hand, the levels of NE had correlations with clinical feature, such as peptic ulcer and/or erosions, ascites and/or pleural effusions, liver atrophy and peripheral platelet count with a statistically significant p value <0.05, <0.02, <0.02 and <0.05, respectively. The results indicate that the sympathetic nervous system is highly disordered in liver cirrhosis, which may lead to the derangement of the systemic microcirculatory system and hepatic failure.
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