Prognostic value of combined detection of alpha-fetoprotein,plasma prothrombin activity,and serum prealbumin in acute-on-chronic liver failure  

作　　者：Rui-Xian Duan Ling Liu Yan Wang Wen-Ming Wu 

机构地区：[1]Department of Infectious Diseases,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Third Hospital of Shanxi Medical University,Tongji Shanxi Hospital,Taiyuan 030032,Shanxi Province,China [2]Department of Pulmonary Diseases,Shanxi Provincial Integrated TCM and WM Hospital,Taiyuan 030013,Shanxi Province,China [3]Clinical Laboratory,Shanxi Provincial People’s Hospital,Taiyuan 030023,Shanxi Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第2期97-104,共8页世界胃肠外科杂志(英文)

摘　　要：BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple prognostic assessment indicators for ACLF,the overall sensitivity and accuracy are relatively low.AIM To investigate the prognostic value of the combined detection of alpha-fetoprotein(AFP),plasma prothrombin activity(PTA),and serum prealbumin(PA)in ACLF.METHODS This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival(n=47)and death(n=40)groups according to their clinical outcomes 3 months posttreatment.All the participants underwent AFP,PTA,and PA level measurements upon admission.Baseline data,as well as AFP,PTA,and PA levels,were comparatively analyzed.Pearson correlation coefficients were utilized to analyze the correlations of AFP,PTA,and PA with different survival outcomes in patients with ACLF.Receiver operating characteristic(ROC)curves and areas under the curves were used to evaluate the predictive value of AFP,PTA,and PA for ACLF prognosis.RESULTS AFP,PTA,and PA levels were markedly decreased in the death group than in the survival group(P<0.05).Pearson analysis indicated a positive association of the AFP,PTA,and PA levels with the survival of patients with ACLF(P<0.05).ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24%and 100.00%,respectively,both of which were notably increased compared to the single-index diagnosis.The ROC of their combined diagnosis was 0.989,significantly surpassing 0.907,0.849,and 0.853 of AFP,PTA,and PA,respectively.No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection(P>0.05).CONCLUSION The combined detection of AFP,PTA,and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF,featuring high sensitivity and s

关 键 词：ALPHA-FETOPROTEIN Prothrombin activity PREALBUMIN Acute-on-chronic liver failure Prognostic value 

分 类 号：R575.3[医药卫生—消化系统]