实用肝脏病杂志2026，Vol.29Issue(1)：73-76,4.DOI:10.3969/j.issn.1672-5069.2026.01.019
COSSH-ACLF Ⅱ评分联合LSR评估HBV相关慢加急性肝衰竭患者预后临床价值研究
Application of COSSH-ACLF Ⅱ score and LSR combination for evaluating prognosis of patients with HBV-related acute-on-chronic liver failure
摘要
Abstract
Objective The aim of this study was to investigate Chinese Group for the Study of Severe Hepatitis B-acute-on-chronic liver failure Ⅱ(COSSH-ACLF Ⅱ)score in combination with liver-to-spleen volume ratio(LSR)in predicting prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods 93 patients with HBV-ACLF were enrolled in our hospital between February 2022 and February 2025,and all were carefully managed with routine comprehensive medical treatment.The patients were followed-up for 90 days and the survival was recorded.The baseline data of patients at admission were collected,including blood,biochemical and coagulation function routine,and upper abdominal CT examination for LSR calculation.Multivariate Logistic regression analysis was used to analyze the related risk factors affecting the prognosis of patients with HBV-ACLF,and receiver operating characteristic curve(ROC)was drawn and the area under the curve(AUC)was calculated to analyze the efficacy of COSSH-ACLF Ⅱ score and LSR in predicting prognosis of patients with HBV-ACLF.Results 45 patients(48.4％)in our series died of liver failure and 48 patients survived,with 90 d survival rate of 51.6％;COSSH-ACLF Ⅱ score in dead group was(8.2±0.7)points,significantly greater than(6.8±0.9)points in survival group(P＜0.05),and LSR was(1.5±0.9),significantly lower than(3.0±1.2)in survival group(P＜0.05);the age,total serum bilirubin,international normalized ratio,model for end-stage liver disease score in dead group were significantly older or higher than those in survival group(P＜0.05);multivariate Logistic regression analysis revealed that COSSH-ACLF Ⅱ score(OR=3.200,95％CI:1.458-7.021)was an independent risk factor affecting the prognosis of patients with HBV-ACLF,while the LSR(OR=0.119,95％CI:0.027-0.520)was a protective factor(P＜0.05);ROC analysis showed that the AUC of COSSH-ACLF Ⅱ score in combination with LSR was 0.940,with a sensitivity of 86.7％and a specificity of 77.1％,much superior to any parameter did alone(P＜0.05).Conclusion Application of COSSH-ACLF Ⅱ score and LSR is efficacious in predicting prognosis of patients with HBV-ACLF,which warrants further clinical investigation.关键词
慢加急性肝衰竭/中国重症乙型肝炎研究学组-慢加急性肝衰竭Ⅱ评分/肝脾体积比值/预后Key words
Acute-on-chronic liver failure/Chinese Group for the Study of Severe Hepatitis B-acute-on-chronic liver failure Ⅱ score/Liver-to-spleen volume ratio/Prognosis引用本文复制引用
马凤锦,陈玉升,周明凯,韩冰莎,赵亮,郑凯娟..COSSH-ACLF Ⅱ评分联合LSR评估HBV相关慢加急性肝衰竭患者预后临床价值研究[J].实用肝脏病杂志,2026,29(1):73-76,4.基金项目
河南省医学科技攻关计划项目(编号:SBGJ202402010) （编号:SBGJ202402010）
