人工肝支持系统治疗急性肝衰竭短期预后的影响因素  

Influencing factors of short-term prognosis of acute liver failure treated with artificial liver support system

作　　者：刘丽华 高阿娜 任麦芳 南雪平 苏娟 LIU Lihua;GAO A′na;REN Maifang;NAN Xueping;SU Juan(Department of Gastroenterology,Xi′an International Medical Center Hospital,Xi′an,Shaanxi 710000,China)

机构地区：[1]西安国际医学中心医院消化内科,陕西西安710000

出　　处：《检验医学与临床》2023年第16期2378-2382,共5页Laboratory Medicine and Clinic

摘　　要：目的分析人工肝支持系统治疗急性肝衰竭患者短期预后的影响因素。方法收集2019年10月至2022年5月在该院治疗的158例急性肝衰竭患者的临床资料。其中66例短期预后不良患者纳入预后不良组,92例短期预后良好患者纳入预后良好组,比较两组基线资料、实验室指标,评价影响患者短期预后的独立危险因素,以及相关因素单独或联合预测患者短期预后的效能。结果预后良好组的住院时间明显短于预后不良组,肝性脑病患者比例、中性粒细胞计数、总胆红素、血清肌酐、国际标准化比值、基于4因子的纤维化指数、终末期肝病模型评分、清蛋白-胆红素(ALBI)评分、中性粒细胞与淋巴细胞比值(NLR)明显低于预后不良组,差异有统计学意义(P<0.05)。ALBI评分与NLR升高是患者短期预后的独立危险因素(P<0.05)。ALBI与NLR联合检测预测患者短期预后的效能最佳,灵敏度为0.883,特异度为0.889。结论ALBI评分与NLR预测人工肝支持系统治疗的肝衰竭患者短期预后价值较高,但ALBI评分与NLR联合检测预测患者短期预后的价值高于ALBI评分、NLR单项检测。Objective To evaluate the the influencing factors of short-term prognostics of patients with acute liver failure treated with artificial liver support system.Methods The clinical data of 158 patients with acute liver failure treated in Xi′an International Medical Center Hospital from October 2019 to May 2022 were collected.Among them,66 patients with poor short-term prognosis were selected into poor prognosis group,92 patients with good short-term prognosis were selected into good prognosis group.Baseline clinical data and laboratory indicators of the two groups were compared,to evaluate the independent risk factors affecting the prognosis of patients and the efficacy of correlation factors alone or combined in predicting the prognosis of patients.Results The hospital stay of the good prognosis group was significant shorter than that of the poor prognosis group,the proportion of patients with hepatic encephalopathy,neutrophil count,total bilirubin,serum creatinine,international standardized ratio,FIB-4 index end-stage liver disease model score,albumin-bilirubin(ALBI)score and neutrophil to lymphocyte ratio(NLR)of the good prognosis group were significantly lower than those of the poor prognosis group,with statistical significance(P<0.05).Increased ALBI score and NLR were independent risk factors for poor prognosis(P<0.05).ALBI combined with NLR had the best predictive prognostic efficacy,the sensitivity was 0.883,the specificity was 0.889.Conclusion ALBI and NLR have high prognostic value in patients with liver failure treated with artificial liver support system,but ALBI combined with NLR has higher prognostic value than ALBI and NLR detected alone.

关 键 词：人工肝 急性肝衰竭 清蛋白-胆红素评分 中性粒细胞与淋巴细胞比值 

分 类 号：R459.9[医药卫生—治疗学]