保健医学研究与实践2025，Vol.22Issue(10)：46-51,6.DOI:10.11986/j.issn.1673-873X.2025.10.08
CRP/ALB与AFP水平对慢加急性肝衰竭患者人工肝治疗后的短期预后的预测价值
Prognostic value of CRP/ALB and AFP for short-term outcomes after artificial liver therapy in patients with acute-on-chronic liver failure
摘要
Abstract
Objective To investigate the predictive value of the serum C-reactive protein/albumin ratio(CRP/ALB)and alpha-fetoprotein(AFP)for short-term prognosis in patients with acute-on-chronic liver failure(ACLF)receiving artificial liver ther-apy,aiming to provide a reference for clinical treatment.Methods Seventy-five patients diagnosed with ACLF who received artificial liver therapy during hospitalization at the General Hospital of Ningxia Medical University from April 2020 to October 2023 were enrolled.According to clinical outcomes at 12 weeks after treatment,patients were assigned to an improved group(n=52)and a deteriorated group(n=23).Pre-treatment clinical data were collected.Multivariate logistic regression analysis was used to analyze factors affecting short-term prognosis after artificial liver therapy.Receiver operating characteristic(ROC)curves and areas under the curve(AUC)were calculated to evaluate the predictive performance of CRP/ALB and AFP.Results Compared with the improved group,the deteriorated group had longer length of hospital stays,and higher incidences of hepatic encephalopathy and hepatorenal syndrome;Child-Turcotte-Pugh(CTP)scores,total bilirubin(TBIL),CRP,and CRP/ALB were all higher in the deteriorated group,with all differences being statistically significant(P<0.05).Multivariate stepwise logistic regression analysis indicated that AFP and CRP/ALB were independent risk factors for poor short-term prognosis(P<0.05).AFP predicted poor short-term prognosis after artificial liver therapy with an AUC of 0.802(95%CI:0.694-0.910),an optimal cutoff of 54.900 ng/mL,a sensitivity of 0.731,and a specificity of 0.870.CRP/ALB showed a higher predictive performance with an AUC of 0.889(95%CI:0.800-0.978),an optimal cutoff of 0.205,a sensitivity of 0.865,and a specificity of 0.826.Combining AFP and CRP/ALB into a predictive model further increased the AUC to 0.904(95%CI:0.814-0.994),with a sensitivity of 0.870 and a specificity of 0.923,indicating superior predictive performance when used together.Conclusion CRP/ALB and AFP can serve as effective predictors of short-term prognosis for ACLF pa-tients after artificial liver therapy,and their combined use further promotes predictive accuracy.关键词
CRP/ALB/AFP/慢加急性肝衰竭/人工肝/短期预后Key words
CRP/ALB/AFP/Acute-on-chronic liver failure/Artificial liver/Short-term prognosis分类
医药卫生引用本文复制引用
Ma Wanlong,Ouyang Hua,Liu Shuaiwei,Tian Yu,Du Pan,Ding Xiangchun,Jiao Yun..CRP/ALB与AFP水平对慢加急性肝衰竭患者人工肝治疗后的短期预后的预测价值[J].保健医学研究与实践,2025,22(10):46-51,6.基金项目
宁夏自然科学基金项目(2024AAC03673) （2024AAC03673）
2021年度人工肝专项基金项目(RGGJJ-2021-024). （RGGJJ-2021-024）
