血清巨噬细胞炎症蛋白3α联合受体相互作用蛋白激酶3水平对乙型肝炎病毒相关慢加急性肝衰竭患者短期预后的预测效能  

Predictive efficacy of serum macrophage inflammatory protein-3αcom-bined with receptor interacting protein kinase 3 levels for the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure

作　　者：李品青 姚煜 丁凯[1] 薛晨祺 邱洁 LI Pinqing;YAO Yu;DING Kai;XUE Chenqi;QIU Jie(The First Department of Tumor and Vascular Disease Intervention,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicinethe Second Hospital of Nanjing,Jiangsu Province,Nanjing210003,China;the Second Department of Tumor and Vascular Disease Intervention,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicinethe Second Hospital of Nanjing,Jiangsu Province,Nanjing210003,China)

机构地区：[1]南京中医药大学附属南京医院,南京市第二医院肿瘤与血管疾病介入一科,江苏南京210003 [2]南京中医药大学附属南京医院,南京市第二医院肿瘤与血管疾病介入二科,江苏南京210003

出　　处：《中国医药导报》2023年第31期97-100,105,共5页China Medical Herald

基　　金：江苏省卫生健康委员会科研项目(M2020088)。

摘　　要：目的探讨血清巨噬细胞炎症蛋白3α(MIP-3α)联合受体相互作用蛋白激酶3(RIPK3)对乙型肝炎病毒相关的慢加急性肝衰竭(HBV-ACLF)患者短期预后的预测效能。方法选择2021年2月至2022年7月南京市第二医院收治的246例HBV-ACLF患者,检测血清MIP-3α、RIPK3水平,根据患者30 d内存活情况将其分为死亡组(73例)和存活组(173例)。比较两组临床资料,分析影响HBV-ACLF患者短期预后的因素及MIP-3α、RIPK3对HBV-ACLF患者预后的预测价值。结果死亡组血清白蛋白水平低于存活组,国际标准化比值、终末期肝病模型(MELD)评分、并发脑病比例及血清总胆红素、MIP-3α、RIPK3水平高于存活组(P<0.05)。MELD评分(OR=3.347,95%CI:1.844~6.073)及血清MIP-3α(OR=2.079,95%CI:1.307~3.309)、RIPK3(OR=2.004,95%CI:1.312~3.060)是HBV-ACLF患者短期预后的影响因素(P<0.05)。MELD评分及血清MIP-3α、RIPK3联合预测HBV-ACLF患者预后的受试者操作特征曲线下面积高于三者单独预测的曲线下面积(P<0.05)。结论HBV-ACLF患者血清MIP-3α、RIPK3水平升高,且与短期内死亡有关,MELD评分及血清MIP-3α、RIPK3联合分析有助于提示患者预后。Objective To investigate the predictive efficacy of serum macrophage inflammatory protein-3α(MIP-3α)combined with receptor interacting protein kinase 3(RIPK3)on the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods A total of 246 patients with HBV-ACLF admitted to the Second Hospital of Nanjing from February 2021 to July 2022 were selected.The serum levels of MIP-3αand RIPK3 were detected.According to the survival situation within 30 days,the patients were divided into the death group(73 cases)and the survival group(173 cases).The clinical data of the two groups were compared,and the factors affecting the short-term prognosis of patients with HBV-ACLF and the predictive value of MIP-3αand RIPK3 for the prognosis of patients with HBV-ACLF were analyzed.Results The serum albumin level in the death group was lower than that in the survival group,the international normalized ratio,model for end-stage liver disease(MELD)score,the proportion of complicated encephalopathy,and the serum total bilirubin,MIP-3α,and RIPK3 levels were higher than those in the survival group(P<0.05).MELD score(OR=3.347,95%CI:1.844-6.073),and serum MIP-3α(OR=2.079,95%CI:1.307-3.309),RIPK3(OR=2.004,95%CI:1.312-3.060)were influential factors for short-term prognosis of HBV-ACLF patients(P<0.05).MELD score combined with serum MIP-3αand RIPK3 predicted the prognosis of HBV-ACLF patients with higher area under the receiver operator charcateristic curve than the area under the curve predicted by the three alone(P<0.05).Conclusion Serum MIP-3αand RIPK3 levels are elevated in HBV-ACLF patients,and are associated with short-term death.Combined analysis of MELD score and serum MIP-3α,RIPK3 helped to indicate the prognosis of patients.

关 键 词：巨噬细胞炎症蛋白3α 受体相互作用蛋白激酶3 乙型肝炎病毒相关的慢加急性肝衰竭 预后 

分 类 号：R512.6[医药卫生—内科学]