西南医科大学学报2026，Vol.49Issue(1)：32-38,7.DOI:10.3969/j.issn.2096-3351.2026.01.007
PRO-C3联合GP73监测对人工肝治疗慢加急性肝衰竭患者短期预后的评估价值
The Prognostic Value of PRO-C3 and GP73 for Short-Term Outcomes in Patients with Acute-on-Chronic Liver Failure Undergoing Artificial Liver Support Therapy
摘要
Abstract
Objective The aim of this study was to explore the evaluative value of dynamic changes in serum N-terminal pep-tide of type Ⅲ procollagen(PRO-C3)and Golgi protein 73(GP73)for the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)undergoing artificial liver treatment.Methods A retrospective analysis was con-ducted on 138 patients with HBV-ACLF who underwent≥3 sessions of artificial liver treatment(85 in the survival group and 53 in the deceased group).Serum levels of PRO-C3 and GP73,as well as routine liver and kidney function indicators,were measured at base-line and 2 weeks after treatment to analyze their correlation with clinical prognosis.Serum PRO-C3 was detected using the Roche cobas® analyzer(ECLIA method);serum GP73 was detected using the ELISA method(Beijing Hotgen Biotech reagent kit).A com-bined prediction model was constructed using multivariate Cox regression,and the predictive performance was evaluated using ROC curves.Results A comparative analysis of the baseline conditions between the two groups revealed that the levels of total bilirubin,cre-atinine,and MELD in the death group were significantly higher than those in the survival group(total bilirubin 535.5±118.7 vs.380.9±108.0 μmol/L,creatinine 96.6±29.6 vs.66.9±28.6 μmol/L,MELD score 33.5±5.5 vs.20.7±4.3;all P<0.001).PRO-C3 and GP73 decreased significantly in the survival group compared with the death group(P<0.001).Multivariate Cox regression analysis showed that the MELD score was an independent risk factor,while the decrease in PRO-C3 and GP73 were protective factors The AUC of the combined dynamic indicators(ΔPRO-C3%+ΔGP73%+MELD)reached 0.993,with a negative predictive value of 89.8%.Grouped by marker reduction(good/partial/no response),with 3-month survival rates of 95.2%,65.5%,and 11.4%,respectively(P<0.001).Conclusion Dynamic monitoring of PRO-C3 combined with GP73 can accurately assess the response to artificial liver treatment,and the predictive model constructed based on them has significant discriminatory value for the 3-month prognosis of patients with HBV-ACLF,especially with outstanding negative predictive performance,providing important guidance for clinical inter-vention.关键词
慢加急性肝衰竭/人工肝/Ⅲ型胶原氨基端前肽/高尔基体蛋白73/预后评估Key words
Acute-on-chronic liver failure/Artificial liver/Type Ⅲ collagen amino-terminal propeptide/Golgi protein 73/Prognostic assessment分类
医药卫生引用本文复制引用
QIAN Zhen,PEI Ying,ZHANG Wei,ZHANG Fan,JIANG Kewen,YIN Dandan,ZHOU Zheng,WANG Shuai..PRO-C3联合GP73监测对人工肝治疗慢加急性肝衰竭患者短期预后的评估价值[J].西南医科大学学报,2026,49(1):32-38,7.基金项目
北京肝胆相照公益基金会人工肝专项基金(RGGJJ-2021-003) （RGGJJ-2021-003）
