Y M Wang, Y S Liu, J Li, Q Zhang, T T Yan, D F Ren, L Zhu, G Y Zhang, Y Yang, J F Liu, T Y Chen, Y R Zhao, Y L He
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The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson <i>χ</i>(2) test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. <b>Results:</b> There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group (<i>P</i> < 0.05). Among the 220 ACLF cases, 158 (71.82%) were infected with the hepatitis B virus (HBV). The incidence rate of infection during hospitalization was 69.09% (152/220). The common sites of infection were intraabdominal (57.07%) and pulmonary infection (29.29%). Pearson correlation analysis showed that PNI and MELD-Na were negatively correlated (<i>r</i> = -0.150, <i>P</i> < 0.05). Multivariate logistic analysis results showed that low PNI score (<i>OR</i>=0.916, 95%<i>CI</i>: 0.865~0.970), ascites (<i>OR</i>=4.243, 95%<i>CI</i>: 2.237~8.047), and hepatorenal syndrome (<i>OR</i>=4.082, 95%<i>CI</i> : 1.106~15.067) were risk factors for ACLF co-infection (<i>P</i> < 0.05). The ROC results showed that the PNI curve area (0.648) was higher than the MELD-Na score curve area (0.610, <i>P</i> < 0.05). The effectiveness of predicting infection risk when PNI was combined with ascites and hepatorenal syndrome complications was raised. Patients with co-infections had a good predictive effect when PNI ≤ 40.625. The sensitivity and specificity were 84.2% and 41.2%, respectively. <b>Conclusion:</b> Low PNI score and ACLF co-infection have a close correlation. Therefore, PNI has a certain appraisal value for ACLF co-infection.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Prognostic nutritional index application value for acute-on-chronic liver failure co-infection].\",\"authors\":\"Y M Wang, Y S Liu, J Li, Q Zhang, T T Yan, D F Ren, L Zhu, G Y Zhang, Y Yang, J F Liu, T Y Chen, Y R Zhao, Y L He\",\"doi\":\"10.3760/cma.j.cn501113-20240109-00021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF). <b>Methods:</b> 220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson <i>χ</i>(2) test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. <b>Results:</b> There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group (<i>P</i> < 0.05). Among the 220 ACLF cases, 158 (71.82%) were infected with the hepatitis B virus (HBV). The incidence rate of infection during hospitalization was 69.09% (152/220). The common sites of infection were intraabdominal (57.07%) and pulmonary infection (29.29%). Pearson correlation analysis showed that PNI and MELD-Na were negatively correlated (<i>r</i> = -0.150, <i>P</i> < 0.05). Multivariate logistic analysis results showed that low PNI score (<i>OR</i>=0.916, 95%<i>CI</i>: 0.865~0.970), ascites (<i>OR</i>=4.243, 95%<i>CI</i>: 2.237~8.047), and hepatorenal syndrome (<i>OR</i>=4.082, 95%<i>CI</i> : 1.106~15.067) were risk factors for ACLF co-infection (<i>P</i> < 0.05). The ROC results showed that the PNI curve area (0.648) was higher than the MELD-Na score curve area (0.610, <i>P</i> < 0.05). The effectiveness of predicting infection risk when PNI was combined with ascites and hepatorenal syndrome complications was raised. Patients with co-infections had a good predictive effect when PNI ≤ 40.625. The sensitivity and specificity were 84.2% and 41.2%, respectively. <b>Conclusion:</b> Low PNI score and ACLF co-infection have a close correlation. 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引用次数: 0
摘要
目的探讨急性-慢性肝衰竭(ACLF)并发感染患者预后营养指数(PNI)的预测价值。方法:选取2011年1月至2016年12月在西安交通大学第一附属医院诊治的220例ACLF患者。根据患者在病程中是否合并感染将其分为感染组和非感染组。比较两组患者的临床数据差异。采用二元逻辑回归分析筛选出与合并感染相关的影响因素。采用接收者操作特征曲线评估 PNI 对 ACLF 合并感染的预测价值。使用独立样本 t 检验和 Mann-Whitney U 秩和检验比较组间测量数据。计数数据采用 Fisher exact 概率检验或 Pearson χ(2) 检验进行分析。相关性分析采用皮尔逊法。与合并感染相关的肝功能衰竭独立风险因素采用多变量逻辑分析法进行分析。结果感染组和非感染组的腹水、肝肾综合征、PNI 评分和白蛋白差异有统计学意义(P r = -0.150,P OR=0.916,95%CI:0.865~0.970),腹水(OR=4.243,95%CI:2.237~8.047)和肝肾综合征(OR=4.082,95%CI:1.106~15.067)是 ACLF 合并感染的危险因素(P P 结论:低 PNI 评分和 ACLF 合并感染是 ACLF 合并感染的危险因素:PNI 低分与 ACLF 合并感染密切相关。因此,PNI 对 ACLF 合并感染有一定的评估价值。
[Prognostic nutritional index application value for acute-on-chronic liver failure co-infection].
Objective: To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF). Methods: 220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ(2) test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results: There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group (P < 0.05). Among the 220 ACLF cases, 158 (71.82%) were infected with the hepatitis B virus (HBV). The incidence rate of infection during hospitalization was 69.09% (152/220). The common sites of infection were intraabdominal (57.07%) and pulmonary infection (29.29%). Pearson correlation analysis showed that PNI and MELD-Na were negatively correlated (r = -0.150, P < 0.05). Multivariate logistic analysis results showed that low PNI score (OR=0.916, 95%CI: 0.865~0.970), ascites (OR=4.243, 95%CI: 2.237~8.047), and hepatorenal syndrome (OR=4.082, 95%CI : 1.106~15.067) were risk factors for ACLF co-infection (P < 0.05). The ROC results showed that the PNI curve area (0.648) was higher than the MELD-Na score curve area (0.610, P < 0.05). The effectiveness of predicting infection risk when PNI was combined with ascites and hepatorenal syndrome complications was raised. Patients with co-infections had a good predictive effect when PNI ≤ 40.625. The sensitivity and specificity were 84.2% and 41.2%, respectively. Conclusion: Low PNI score and ACLF co-infection have a close correlation. Therefore, PNI has a certain appraisal value for ACLF co-infection.