Objective To analyze the dynamic changes of serum alanine transaminase (ALT) , aspartate aminotransferase (AST) , total bilirubin (TBil) , prothrombin time (PT) levels and their prognostic significance in acute-on-chronic hepatitis B liver failure.Methods 499 cases of hepatitis B patients with acute-on-chronic liver failure were divided into the survival group and death group according to the clinical outcomes.After admission, serum ALT, AST, TBil, and PT were detected every week.The dynamic changes of these indicators and relationship with prognosis of these patients were analyzed.Results 1.Serum ALT levels on admission were comparable between survival group and death group.However, serum ALT levels in patients of death group were significantly higher than those in survival group from 2nd-6th week (P<0.05) , and serum AST levels in patients of death group were significantly higher than those of survival group from admission to 5th week (P<0.05) .ALT and AST levels showed a downward trend over time.Six weeks later ALT, AST levels between the two groups were basically normal and comparable.2.The TBil and PT levels in patients of death group were significantly higher than those of survival group at every week (P<0.001) .Within the first week, TBil and PT levels increased in both groups.However, from the second week, the TBil and PT levels gradually decreased from the peak in survival group, but elevated in death group over time.Conclusion In patients with acute-on-chronic liver failure, the dynamic changes of serum ALT, AST, TBil and PT levels in early stage after admission could predict the clinical outcomes, which could be useful in prognostic evaluation.
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