MCP-1结合CLIF器官衰竭评分在预测慢加急性肝衰竭患者肝移植术后并发症中的作用  

Research on the role of MCP-1 combined with CLIF-COFs for predicting complications in patients with HBV related acute onchronic liver failure undergoing liver transplantation

作　　者：郭庆良[1] 段斌伟[1] 卢实春[1] 高大明[1] 李宁[1] 

机构地区：[1]首都医科大学附属北京佑安医院普外中心,北京100069

出　　处：《国际外科学杂志》2015年第12期799-803,F0003,共6页International Journal of Surgery

基　　金：北京市科技计划（No.D131100005313004;No.2012DFA30850）;科技部支撑项目（No.2012BA106801）

摘　　要：目的探讨细胞因子结合CLIF器官衰竭评分在预测HBV相关慢加急性肝衰竭患者肝移植术后并发症中的作用。方法37例HBV相关ACLF肝移植患者，分为有并发症组（n=15）和无并发症组（n：22）。采集术前及术后1、3、5、7d的外周静脉血，应用Bio—Plex200LUMINEX液相芯片技术测定27种细胞因子水平。应用Logistic回归和Cox回归分析细胞因子、CLIF器官衰竭评分与肝移植术后总体并发症之间的关系。结果ACLF并发症组术后细胞因子G—CSF和MCP-1水平高于ACLF无并发症组（P〈0．05）。Cox回归分析显示，MCP-1及CLIF器官衰竭评分是肝移植术后发生并发症较好的的预测指标（AUC：0．821，95％CI：0．668～0．974；AUC：0．738，95％CI：0．578～0．898）。CLIF器官衰竭评分结合MCP-1（AUC：0．839，95％CI：0．703—0．975）对肝移植术后并发症的预测优于CLIF器官衰竭评分、MCP-1的单独预测。结论CLIF器官衰竭评分结合细胞因子MCP-1水平能很好地预测HBV相关慢加急性肝衰竭患者肝移植术后早期并发症的发生。Objective To investigate the role of cytokines combined with CLIF Consortium organ failure score （ CLIF- COFs） in determining the prognosis of liver transplant in hepatitis B- related acute- onchronic liver failure （HB-ACLF） patients. Methods Thirty-seven cases of HB-ACLF patients undergoing liver transplantation were divided into HB-ACLF patients with complications group （n = 15 ） and those without complications （n = 22）. Plasma were prospectively collected immediately before LT and on the 1st, 3rd, 5th, 7th day after LT in HB-ACLF patients. The serum levels of twenty-seven cytokines were determined by 200 LUMINEX liquid chip technology. Cytokines and CLIF-COFs were analyzed with logistic regression and the receiver operating characteristic to confirm the correlation with the total complications post-LT. Results The serum levels of post-transplant G-CSF and MCP-1 in HB-ACLF patients with complications were higher than those of without complications （P 〈 0.05）. The COX analysis indicated that MCP-1 and CLIF-COFs were predictors of post-LT complications [ AUC：0. 821, 95% CI： O. 668-0. 974; AUC：0. 738,95% CI： 0. 578-0. 898 ]. The discriminatory power of MCP-combined with CLIF-COFs [ AUC： 0. 839, 95% C1： 0. 703-0. 975 ] was better than that of either. Conclusions MCP-1 combined with CLIF organ failure score can better predict the short-term outcomes of liver transplantation in HB-ACLF patients.

关 键 词：细胞因子 单核细胞趋化蛋白-1 慢加急性肝衰竭 肝移植 

分 类 号：R512.6[医药卫生—内科学]