甲胎蛋白在乙型肝炎病毒感染相关慢加急性肝衰竭诊治中的价值  

Value of alpha-fetoprotein on the diagnosis and treatment of hepatitis B virus infectionrelated acute-on-chronic liver failure

作　　者：赵琴 杨军杰[3] 钟炎平 毛静 雷旭 胡小丽 郭鹏 胡波 谭华炳 Zhao Qin;Yang Junjie;Zhong Yanping;Mao Jing;Lei Xu;Hu Xiaoli;Guo Peng;Hu Bo;Tan Huabing(Department of Infectious Diseases,Renmin Hospital,Hubei University of Medicine,Hubei Shiyan 442000,China;Department of Clinical Laboratory,Fang County Renmin Hospital,Hubei Shiyan 442100,China;Department of Cardiology,Heyuan People’s Hospital,Guangdong Heyuan 517001,China;Shiyan Key Laboratory of Virology,Hubei University of Medicine,Hubei Shiyan 442000,China;Department of Internal Medicine,Wuhan Jinyintan Hospital,Tongji Medical College of Huazhong University of Science and Technology,Hubei Wuhan 430048,China)

机构地区：[1]湖北医药学院附属人民医院感染性疾病科,湖北十堰442000 [2]房县人民医院检验科,湖北十堰442100 [3]河源市人民医院心血管内科,广东河源517001 [4]湖北医药学院病毒学十堰市重点实验室,湖北十堰442000 [5]华中科技大学同济医学院附属武汉金银潭医院普通内科,湖北武汉430048

出　　处：《中国肝脏病杂志（电子版）》2024年第3期32-35,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);2018年湖北省教育厅基金项目(B2018117);2018年度十堰市科技局引导性项目(18Y115);2021年度十堰市科技局引导性科研项目(21Y63);2022年度十堰市科技局引导性科研项目(22Y69);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 infection-related acute liver failure,HBV-ACLF)是在乙型肝炎病毒(hepatitis B virus,HBV)感染导致的慢性肝炎和终末期肝病基础上发生的以肝脏功能急性衰竭为特征的临床综合征,是中国最主要的肝衰竭类型,短期死亡率极高。基础研究发现甲胎蛋白(alpha fetoprotein,AFP)水平与HBV-ACLF短期预后相关,可用于预测肝衰竭患者的短期预后。临床研究发现由中性粒细胞、乙型肝炎病毒表面抗原和AFP组成的NHA-ACLF模型,由总胆红素、年龄、血肌酐、国际标准化比值和AFP组成的TACIA评分模型,含AFP的人工肝支持系统-预后模型(APM)以及AFP的四分位数分层等对HBV-ACLF短期预后预测价值优于单用AFP。Hepatitis B virus infection-related acute liver failure(HBV-ACLF)was a clinical syndrome characterized by acute liver failure on the basis of chronic hepatitis and end-stage liver disease caused by hepatitis B virus(HBV)infection,which was the main type of liver failure in China and with extremely high short-term mortality.Basic research had found that the level of AFP was related to the short-term prognosis of HBV-ACLF,which could be used to predict the short-term prognosis of patients with liver failure.Clinical studies had found that the NHA-ACLF model(comprising neutrophils,hepatitis B virus surface antigen and AFP),the TACIA scoring model(including total bilirubin,age,serum creatinine,international normalized ratio and AFP),the artificial liver support system prognosis model incorporating AFP(APM),and AFP quartile stratification all provided superior predictive value for short-term prognosis in patients with HBV-ACLF compared to AFP alone.

关 键 词：甲胎蛋白 肝炎病毒 乙型 肝衰竭 慢加急性 疗效 预后 

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