临床肝胆病杂志2025，Vol.41Issue(8)：1556-1562,7.DOI:10.12449/JCH250814
乙型肝炎核心抗体定量对国际标准化比值正常的乙型肝炎肝硬化失代偿期患者预后的预测价值
Value of quantitative hepatitis B core antibody in predicting the prognosis of decompensated hepatitis B cirrhosis patients with normal international normalized ratio
摘要
Abstract
Objective To determine the serum level of quantitative hepatitis B core antibody(qAnti-HBc)in decompensated hepatitis B cirrhosis patients with normal international normalized ratio(INR),and to investigate its prognostic value in this target population.Methods A total of 120 decompensated hepatitis B cirrhosis patients with normal INR who were diagnosed and treated in Tianjin Third Central Hospital from October 1,2018 to April 1,2021 were enrolled.Baseline indicators were collected,the serum level of qAnti-HBc was measured,and the prognosis was followed up.According to the prognosis,the patients were divided into survival group and death group.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between groups.Univariate and multivariate Cox regression analyses were used to investigate the candidate variables affecting the prognosis and establish a prognostic model for this population,and the receiver operating characteristic(ROC)curve was plotted.Results The patients enrolled were followed up for 32.17±13.09 months,and there were 99 patients(82.5%)in the survival group and 21 patients(17.5%)in the death group.There were significant differences between the survival group and the death group in sex(χ2=2.151,P=0.014),age(t=-3.218,P=0.003),total bilirubin(Z=-0.901,P=0.027),albumin(t=3.353,P=0.001),and Child-Pugh class(χ2=1.144,P=0.010).The univariate and multivariate Cox regression analyses showed that serum qAnti-HBc(hazard ratio[HR]=0.57,95%confidence interval[CI]:0.32-1.00,P=0.043),age(HR=1.06,95%CI:1.00-1.12,P=0.044),sex(HR=3.82,95%CI:1.46-10.00,P=0.006),platelet count(HR=0.98,95%CI:0.97-1.00,P=0.037),and albumin(HR=0.86,95%CI:0.79-0.95,P=0.002)were independent risk predictive factors for the prognosis of decompensated hepatitis B cirrhosis patients with normal INR.Based on these factors,a predictive model was established as h(t,x)/h0(t)=exp(1.34X1+0.06X2-0.14X3-0.02X4-0.57X5),where X1=sex,X2=age,X3=albumin,X4=platelet count,X5=qAnti-HBc.This predictive model had an area under the ROC curve of 0.842,with a sensitivity of 0.79,a specificity of 0.73,and a C-index of 0.85.Conclusion In decompensated hepatitis B cirrhosis patients with normal INR(0.8-1.2),serum qAnti-HBc is one of the independent risk predictive factors for death,and the predictive model established based on the combination of serum qAnti-HBc and other indicators can effectively predict the prognosis of patients.关键词
乙型肝炎核心抗体/肝硬化/预后/危险因素Key words
Hepatitis B Core Antibody/Liver Cirrhosis/Prognosis/Risk Factors引用本文复制引用
徐佰国,王佳音,向慧玲..乙型肝炎核心抗体定量对国际标准化比值正常的乙型肝炎肝硬化失代偿期患者预后的预测价值[J].临床肝胆病杂志,2025,41(8):1556-1562,7.基金项目
天津市卫生健康科技项目重点学科专项(TJWJ2022XK029)Science and Technology Project of Tianjin Health Commission for Special Supporting Key Disciplines(TJWJ2022XK029) （TJWJ2022XK029）
