Prediction of serum M30 and M65 levels for the short-term prognosis of patients with hepatitis B virus related acute-on-chronic liver failure during artificial liver support system therapy

Abstract

Objective To analyze the dynamic changes of serum M30 and M65 levels in patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) during artificial liver support system(ALSS) therapy, and to explore their predictive efficiency and clinical values for short-term prognosis of HBV-ACLF. Methods Seventy-six patients with HBV-ACLF who underwent ALSS therapy for the first time from May 2016 to May 2019 in the First Hospital of Jiaxing were selected.The patients were divided into improvement group (38 cases) and non-recovered group (38 cases)according to their prognosis, and 38 healthy persons were selected as control group during the same period.The serum levels of M30 and M65 were detected by enzyme-linked immunosorbent assay(ELISA). The predictive values of M30 and M65 levels for short-term prognosis in patients receiving ALSS were calculated by receiver operating characteristic analysis curve (ROC). M30 and M65 levels before and after ALSS were compared by two-way repeated measures analysis of variance. Results The levels of M30 and M65 in the improvement group, non-recovered group and control group were significantly different before the first ALSS therapy (F=109.36 and 90.42, respectively, both P 0.05). However, after twice ALSS therapy, the levels of M30 and M65 in non-recovered group were significantly higher than those in improvement group (t=30.699 and 64.777, respectively, both P<0.01). Moreover, after the second ALSS therapy, the levels of M30 and M65 were both significantly lower compared to those after the first-time therapy in the improvement group (t=3.350 and 5.932, respectively, both P<0.01). The areas under curve (AUC) of M30, M65 and the combination of M30 and M65 for prognosis prediction were 0.796, 0.844 and 0.906, respectively. The AUC of combination of M30 and M65 was significantly higher than M30 or M65 alone (Z=2.163 and 2.141, respectively, P=0.031 and 0.032, respectively). The cut-off values of M30 and M65 were 591.91 and 924.50 U/L, respectively. The sensitivity and specificity of combined M30 and M65 were 94.7% and 82.5%, respectively. Conclusions Serum M30 and M65 levels can predict the short-term prognosis of HBV-ACLF patients after ALSS therapy.The combination of M30 and M65 is of better diagnostic value. Key words: Liver, artificial; HBV-related acute-on-chronic liver failure; M30; M65