赣南医科大学学报2025，Vol.45Issue(10)：966-971,6.DOI:10.3969/j.issn.2097-7174.2025.10.008
慢加急性肝衰竭患者非生物型人工肝支持系统治疗后总胆红素清除率与90天短期预后关系
Association between total bilirubin clearance rate following non-biological artificial liver support system therapy and 90-day short-term prognosis in patients with acute-on-chronic liver failure
刘长虹 1李金垄 1黄锦晶2
作者信息
- 1. 赣州市第五人民医院肝病科/赣州市肝病研究所
- 2. 赣南医科大学第二附属医院,江西 赣州 341000
- 折叠
摘要
Abstract
Objective:To explore the relationship between the total bilirubin clearance rate(TBCR)of patients with acute-on-chronic liver failure(ACLF)after treatment with non-biological artificial liver support system(ALSS)and their short-term prognosis within 90 days.Methods:A total of 90 patients with ACLF treated with the non-biological ALSS centered on PDF at The Fifth People's Hospital of Ganzhou from August 2021 to December 2023 were included in the study.Relevant clinical information of the patients was collected.The relationship between TBCR and the prognosis of ACLF was analyzed by restrictive cubic spline analysis.The Cox regression model was used to analyze the influencing factors related to the 90-day prognosis of ACLF patients treated with non-biological ALSS.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of prognostic predictive indicators.Results:The 90-day transplantation-free survival rate of 90 patients was 56.67%.Compared with patients who died within 90 days,those who survived without transplantation within 90 days had a milder disease severity(P＜0.001),fewer treatments for non-biological ALSS(P＜0.001),and a higher average TBCR(P=0.010).Cox regression analysis showed that MELD score[HR(95%CI):1.10(1.04-1.15),P＜0.001],TBCR[HR(95%CI):0.13(0.04-0.43),P=0.001]and the number of treatments for non-biological ALSS[HR(95%CI):1.43(1.09-1.88),P=0.010]was an independent influencing factor for predicting poor short-term prognosis.Restricted cubic spline analysis showed that TBCR was positively correlated with transplantation-free survival rate[HR(95%CI):0.23(0.08-0.67),P=0.007].The Area under the ROC curve(AUC)(95%CI)of TBCR in predicting 90-day transplantation-free survival was 0.658(0.543-0.772)(P=0.011),and the sensitivity and specificity were 62.7%and 66.7%,respectively.Stratified analysis of TBCR showed that compared with ACLF patients with TBCR＜42.6%,ACLF patients with TBCR≥42.6%had a higher 90-day survival rate(P=0.006).Conclusion:Among patients who received non-biological ALSS treatment,TBCR was positively correlated with the 90-day short-term prognosis of ACLF.Therefore,it can be used as a prognostic biomarker for ACLF.关键词
肝衰竭/非生物型人工肝/预后预测/总胆红素清除率Key words
Liver failure/Artificial liver/Prognostic prediction/Total bilirubin clearance rate分类
医药卫生引用本文复制引用
刘长虹,李金垄,黄锦晶..慢加急性肝衰竭患者非生物型人工肝支持系统治疗后总胆红素清除率与90天短期预后关系[J].赣南医科大学学报,2025,45(10):966-971,6.
