Objective To investigate the short- term prognosis in hepatitis B virus (HBV) - related acute- on- chronic liver failure (ACLF) treated with artificial liver support system (ALSS) and its relationship with clinical indices including HBeAg and to provide reference for the timely, accurate prognostic evaluation of HBV- related ACLF.Methods A retrospective analysis was performed on the clinical data of 81 patients with HBV- related ACLF (55 HBeAg- negative cases and 26 HBeAg- positive cases) who received ALSS treatment and comprehensive medical treatment.The HBeAg- negative cases and HBeAg- positive cases were compared in terms of treatment outcome and laboratory indices including alanine aminotransferase, total bilirubin, albumin, prealbumin (PA) , cholinesterase, international normalized ratio (INR) , blood ammonia, and alpha- fetoprotein (AFP) .Comparison between two groups was made by chi- square test or non- parametric test.Results There was no significant difference in treatment outcome between the HBeAg- negative cases and HBeAg- positive cases (P = 0.158) .There were significant differences in PA, AFP, and INR between the patients with response to treatment and those without response to treatment (P < 0.000 1, P = 0.000 5, and P < 0.000 1) .The receiver operating characteristic (ROC) curves of PA, AFP, and INR were drawn, and their areas under the ROC curves were 0.875, 0.795, and 0.792, respectively.Conclusion There is no significant difference in treatment outcome between HBeAg- positive and HBeAg- negative patients with HBV- related ACLF treated with ALSS.PA, AFP, and INR can be used as accurate indices for prognostic evaluation of HBV- related ACLF.
[1]KATOONIZADEH A, LALEMAN W, VERSLYPE C, et al.Early features of acute-on-chronic alcoholic liver failure:a prospectivecohort study[J].Gut, 2010, 59 (11) :1561-1569.
|
[2]Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, CMA;Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, CMA.Guideline for diagnosis and treatment of liver failure[J/CD].Chin J Transplant:Electronic Edition, 2013, 7 (1) :48-56. (in Chinese) 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南 (2012年版) [J/CD].中华移植杂志:电子版, 2013, 7 (1) :48-56.
|
[3]ZHANG AM, XIN SJ.Virus infection and liver failure[J].J Clin Hepatol, 2012, 28 (10) :729-731. (in Chinese) 张爱民, 辛绍杰.病毒感染与肝功能衰竭[J].临床肝胆病杂志, 2012, 28 (10) :729-731.
|
[4]ZHANG WH, JIA WL, ZHOU ZR, et al.Investigation on the method and safety of the non-heparinized plasma exchange therapy in treating patients with hepatic failure[J].J Clin Hepatol, 2012, 28 (1) :50-52. (in Chinese) 张文华, 贾文玲, 周子英, 等.无肝素血浆置换治疗肝功能衰竭的方法及安全性探讨[J].临床肝胆病杂志, 2012, 28 (1) :50-52.
|
[5]BAHIRWANI R, SHAKED O, BEWTRA M, et al.Acute-on-chronic liver failure before liver transplantation:impacton posttransplant outcomes[J].Transplantation, 2011, 92 (8) :952-957.
|
[6]MO ZS, LI XH, LEI ZY, et al.Comparison of the clinical features of HBV induced acute-on-chronic liver failure with diferent HBeAg status[J].China Mod Med, 2012, 19 (23) :74-78. (in Chinese) 莫志硕, 李新华, 雷姿颖, 等.不同HBeAg状态乙型肝炎慢加急性肝衰竭的临床特点比较[J].中国当代医药, 2012, 19 (23) :74-78.
|
[7]NIE XH, XIANG HL, HAN T, et al.Prediction of prealbumin rate for liver failure patients prognosis[J].Shandong Med J, 2012, 52 (44) :56-59. (in Chinese) 聂新华, 向慧玲, 韩涛, 等.前白蛋白变化率对肝衰竭预后的预测作用[J].山东医药, 2012, 52 (44) :56-59.
|
[8]SCHMIDT LE, DALHOFF K.Alpha-fetoprotein is a predictor of outcome in acetaminophen-induced liver injury[J].Hepatology, 2005, 41 (1) :26-31.
|