Prognostic value of inflammation-related model in hepatitis B acute-on-chronic liver failure.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Clinical and Experimental Medicine Pub Date : 2024-11-18 DOI:10.17219/acem/192624

Huaqian Xu, Xue Li, Yue Zhuo, Chunyan Li, Chengzhi Bai, Jie Chen, Shanhong Tang

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Abstract

Background: Acute-on-chronic liver failure (ACLF) is characterized by rapid onset, rapid development and a high short-term mortality rate. Systemic inflammation exerts an effect on the disease progression of ACLF.

Objectives: The purposes of this study were to explore the clinical significance that the inflammatory response has on the disease process of hepatitis B virus acute-on-chronic liver failure (HBV-ACLF) patients, to further compare the values of different inflammation-related biomarkers in the prognosis evaluation of HBV-ACLF patients, and to combine inflammatory-related markers to establish a new prediction model.

Material and methods: Baseline admission data and 90-day outcomes were collected from 247 patients who met the inclusion criteria. According to the 90-day survival situation, they were divided into a survival group and a death group. The differences in baseline data and inflammation levels between the 2 groups were compared. A regression model was used to analyze the risk factors for 90-day mortality and establish a new model.

Results: The study found that the differences between the survival group and the death group were statistically significant in terms of age, total bilirubin (Tbil), prothrombin time (PT), international standardized ratio (INR), inflammation level, and model for end-stage liver disease (MELD) series scores (p < 0.05). The monocyte-to-lymphocyte ratio (MLR)-integrated iMELD model (MLR-iMELD) can effectively predict the 90-day survival rate of HBV-ACLF patients. The area under the receiver operating characteristic (ROC) curve (AUROC) of the new model was 0.792, and the best cutoff for predicting the prognosis of 90 days for patients was -0.33 (sensitivity 0.577 and specificity 0.898).

Conclusions: The higher the level of inflammation in patients with HBV-ACLF, the greater the risk of 90-day death. Compared with other inflammation-related markers, the MLR-iMELD model can better predict the 90-day survival rate of HBV-ACLF patients.

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炎症相关模型在乙型肝炎急性-慢性肝衰竭中的预后价值。

背景：急性慢性肝衰竭（ACLF）的特点是起病急、发展快、短期死亡率高。全身炎症对 ACLF 的疾病进展有影响：本研究旨在探讨炎症反应对乙型肝炎病毒急性慢性肝衰竭（HBV-ACLF）患者疾病进程的临床意义，进一步比较不同炎症相关生物标志物在 HBV-ACLF 患者预后评估中的价值，并结合炎症相关标志物建立新的预测模型：材料：收集了符合纳入标准的 247 名患者的入院基线数据和 90 天结果。根据 90 天的生存情况，将他们分为生存组和死亡组。比较两组患者基线数据和炎症水平的差异。采用回归模型分析 90 天死亡率的风险因素，并建立新的模型：研究发现，生存组和死亡组在年龄、总胆红素（Tbil）、凝血酶原时间（PT）、国际标准化比值（INR）、炎症水平和终末期肝病模型（MELD）系列评分方面的差异具有统计学意义（P < 0.05）。单核细胞与淋巴细胞比值（MLR）整合 iMELD 模型（MLR-iMELD）能有效预测 HBV-ACLF 患者的 90 天生存率。新模型的接收者操作特征曲线下面积（ROC）为0.792，预测患者90天预后的最佳临界值为-0.33（灵敏度为0.577，特异度为0.898）：结论：HBV-ACLF 患者的炎症水平越高，90 天死亡风险越大。与其他炎症相关指标相比，MLR-iMELD 模型能更好地预测 HBV-ACLF 患者的 90 天生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.