转化医学杂志2026，Vol.15Issue(10)：1642-1646,5.DOI:10.3639/j.issn.2095-3097.2026.10.002
DPMAS联合血浆置换治疗HBV相关肝衰竭患者预后的影响因素分析及风险预测列线图模型构建
Analysis of Prognostic Factors and Construction of a Risk Prediction Nomogram Model for Patients with HBV-Related Liver Failure Treated with DPMAS Combined with Plasma Exchange
摘要
Abstract
Objective To investigate the prognosis of patients with hepatitis B virus(HBV)-related liver failure treated with double plasma molecular adsorption system(DPMAS)combined with plasma exchange,and analyze the relevant factors affecting the prognosis,so as to construct a nomogram model for risk stratification.Methods A total of 198 patients with HBV-related liver failure admitted to Huai'an First Hospital Affiliated to Nanjing Medical University from October 2022 to November 2025 were retrospectively enrolled as study subjects.They were divided into a poor prognosis group(n=63)and a good prognosis group(n=135)according to the therapeutic effect after treatment.Clinical data of the patients were collected to screen the prognostic factors,and a nomogram prediction model was constructed.Results The poor prognosis group had older age,higher proportion of liver cirrhosis and higher Chronic Liver Failure-Sequential Organ Failure Assessment(CLIF-SOFA)score,later intervention timing,as well as lower total bilirubin(TBil)clearance rate,neutrophil-to-lymphocyte ratio(NLR)decline rate,total cholesterol and albumin levels than the good prognosis group(P<0.05).Logistic regression analysis showed that age,liver cirrhosis,intervention timing and CLIF-SOFA score were risk factors for the prognosis of patients with HBV-related liver failure,while TBil clearance rate and NLR decline rate were protective factors(P<0.05).A nomogram prediction model was constructed based on the above six independent influencing factors.ROC curve evaluation showed that the area under the curve of the model was 0.949(95％CI:0.922-0.977),and the area under the calibration curve was 0.940(95％CI:0.934-0.949).The calibration curve indicated good model calibration;the Hosmer-Lemeshow test yielded χ²=4.526,P=0.807.Conclusion Age,liver cirrhosis,intervention timing,CLIF-SOFA score,TBil clearance rate and NLR decline rate are relevant factors affecting the prognosis of patients with HBV-related liver failure treated with DPMAS combined with plasma exchange.The nomogram model constructed based on these six indicators has good discrimination and calibration,and can provide a quantitative basis for early clinical identification of high-risk patients and optimization of treatment strategies.关键词
乙型肝炎病毒/肝衰竭/预后/血浆置换/双重血浆分子吸附/预测模型Key words
hepatitis B virus/liver failure/prognosis/plasma exchange/double plasma molecular adsorption system/prediction model引用本文复制引用
卢慧,高珣,王小林,包莉丽..DPMAS联合血浆置换治疗HBV相关肝衰竭患者预后的影响因素分析及风险预测列线图模型构建[J].转化医学杂志,2026,15(10):1642-1646,5.基金项目
江苏省自然科学基金项目(BK20230840) （BK20230840）
