炎症和免疫指标对乙型肝炎病毒感染相关慢加急性肝衰竭预后判断价值研究进展  

Research progress on the value of inflammatory and immune indexes in predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure

作　　者：毛静 刘鑫华 杨军杰 钟炎平 赵琴[3] 蔡美和 雷旭 郭鹏 胡波 刘志新 谭华炳 Mao Jing;Liu Xinhua;Yang Junjie;Zhong Yanping;Zhao Qin;Cai Meihe;Lei Xu;Guo Peng;Hu Bo;Liu Zhixin;Tan Huabing(Department of Infectious Diseases,Hepatology Institute,Renmin Hospital,Hubei University of Medicine,Shiyan 442000,Hubei Province,China;Department of Cardiology,Heyuan People’s Hospital,Heyuan 517001,Guangdong Province,China;Department of Clinical Laboratory,Fangxian People’s Hospital,Shiyan 442100,Hubei Province,China;Department of Traditional Chinese Medicine,Zhushan People’s Hospital,Shiyan 442200,Hubei Province,China;Shiyan Key Laboratory of Virology,Hubei University of Medicine,Shiyan 442000,Hubei Province,China)

机构地区：[1]湖北医药学院附属人民医院感染性疾病科肝病研究所,湖北十堰442000 [2]河源市人民医院心血管内科,广东河源517001 [3]房县人民医院检验科,湖北十堰442100 [4]竹山县人民医院中医科,湖北十堰442200 [5]湖北医药学院病毒学十堰市重点实验室,湖北十堰442000

出　　处：《中国肝脏病杂志（电子版）》2024年第1期18-21,共4页Chinese Journal of Liver Diseases：Electronic Version

基　　金：国家自然科学基金青年科学基金资助项目(81902066);湖北省卫生健康委员会2019~2020年度科研项目(WJ2019F051);2019年度十堰市科技局引导性科研项目(19Y59、19Y60);2022年肝胆相照公益基金会“人工肝专项基金”(iGandanF-1082022-RGG030)。

摘　　要：乙型肝炎病毒感染相关慢加急性肝衰竭(hepatitis B virus-related acute-on-chronic liver failure,HBV-ACLF)是在慢性乙型肝炎病毒感染导致的慢性肝病基础上,短期内出现急性肝功能失代偿的临床综合征。HBV-ACLF具有病情进展迅速、治疗效果差、死亡率高的特点。炎症和免疫应答是HBV-ACLF发生、发展及产生多器官、组织损伤的重要原因。本文对超敏C反应蛋白、降钙素原、白细胞介素类、淋巴细胞亚群类、趋化因子等炎症指标,以及超敏C反应蛋白/白蛋白比值、中性粒细胞/淋巴细胞比值、血小板/白细胞比值等多因素指标在HBV-ACLF病情及预后判断中的应用进行综述,发现动态观察炎症和免疫相关指标对HBV-ACLF预后判断、治疗方式选择等具有指导意义,且多因素指标判断HBV-ACLF患者预后的灵敏度及特异度优于单因素指标。炎症和免疫指标对HBV-ACLF患者预后判断具有指导意义。Hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF)is a clinical syndrome of acute liver dysfunction in the short term on the basis of chronic liver disease caused by chronic hepatitis B virus infection.HBV-ACLF is characterized by rapid progression,poor therapeutic effect and high mortality.Inflammation and immune response are important causes of the occurrence,development and multiple organ and tissue damage of HBV-ACLF.This article reviewed the application of inflammatory factors such as high-sensitivity C-reactive protein,procalcitonin,interleukins,lymphocyte subsets,chemokines and other inflammatory indicators,as well as high-sensitivity C-reactive protein/albumin ratio,neutrophil/lymphocyte ratio,platelet/white blood cell ratio and other multi-factor indicators on the diagnosis and prognosis of HBV-ACLF.It was found that the dynamic observation of inflammation and immune-related indicators had guiding significance for the prognosis of HBV-ACLF and the choice of treatment methods,the sensitivity and specificity of multi-factor indicators in the prognosis of HBV-ACLF patients were better than those of single-factor indicators.Inflammation and immune indicators had guiding significance for the prognosis of patients with HBV-ACLF.

关 键 词：肝衰竭 慢加急性 肝炎病毒 乙型 炎症 免疫 预后判断 价值 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]