肝脏 ›› 2025, Vol. 30 ›› Issue (6): 793-795.

• 肝功能衰竭 • 上一篇    下一篇

免疫炎症指标与HBV相关慢加急性肝衰竭患者预后的相关性

魏丽, 施文娟, 周晓丽, 杨学芳, 马海文, 万红   

  1. 730046 甘肃 兰州市第二人民医院感染科/肝病三科
  • 收稿日期:2024-05-09 出版日期:2025-06-30 发布日期:2025-08-08
  • 通讯作者: 施文娟,Email:1156179420@qq.com
  • 基金资助:
    甘肃省卫生健康行业科研项目(GSWSQN2023-11);兰州市科技发展指导性计划项目(2020-ZD-128)

The correlation between immune inflammatory markers and the prognosis of patients with acute-on-chronic liver failure associated with HBV infection

WEI Li, SHI Wen-juan, ZHOU Xiao-li, YANG Xue-fang, MA Hai-wen, WAN Hong   

  1. The Sencond People’s Hospital of Lanzhou, Gansu 730046, China
  • Received:2024-05-09 Online:2025-06-30 Published:2025-08-08
  • Contact: SHI Wen-juan,Email:1156179420@qq.com

摘要: 目的 探讨免疫炎症指标与HBV相关慢加急性肝衰竭(HBV-ACLF)患者预后的相关性。方法 收集2020年1月至2022年12月在兰州市第二人民医院住院的HBV-ACLF患者临床资料,比较好转组与死亡组患者的年龄、性别、血细胞计数、感染指标、全身免疫炎症指数(SII)、MELD评分等,并将血细胞计数、感染指标、SII与MELD评分进行相关性分析。结果 98例临床资料完整的HBV-ACLF患者中,好转组65例,PLT、IL-6与MELD评分分别为:(122.2±50.5)×109、17.9(8.6,23.1)pg/mL、(18.8±5.2)分;死亡组33例,PLT、IL-6与MELD评分分别为:(91.7±38.1)×109、16.1(11.5,43.3)pg/mL、(21.9±4.8)分,两组间差异有统计学意义(t=2.186,P=0.034;Z=0.748,P=0.045;t=2.048,P=0.046)。将血细胞计数、感染指标、SII与MELD评分做相关性分析,结果显示:白细胞计数(WBC)、中性粒细胞计数(NEU)、降钙素原(PCT)与MELD评分呈正相关(r=0.312,P=0.027;r=0.419,P=0.002;rs=0.507,P<0.001),PLT与MELD评分呈负相关(r=-0.350,P=0.013),其他指标与MELD评分均无相关性(P>0.05)。结论 入院时WBC、NEU、PCT水平升高、PLT水平降低与HBV-ACLF患者短期预后相关。

关键词: 免疫炎症指标, HBV相关慢加急性肝衰竭, 预后, 相关性

Abstract: Objective To investigate the relationship between immune inflammatory markers and the prognosis of patients with acute-on-chronic liver failure associated with hepatitis B viral infection (HBV-ACLF). Methods A total of 98 HBV-ACLF patients with complete clinical data admitted to the Second People’s Hospital of Lanzhou from January 2020 to December 2022 were collected. The patients were divided into an improvement group (N=65 cases) and a death group(N=33 cases)based on their clinical outcomes. The differences in age, gender, blood cell count, infection indicators, systemic immune inflammation index (SII), and Model for End-Stage Liver Disease (MELD) scores were analyzed among the two groups of patients. Correlation analysis was conducted between blood cell count, infection indicators, SII, and MELD scores of the two groups of patients. Results In the improvement group,platelet count (PLT), interleukin-6 (IL-6), and MELD scores are 122.2±50.5,17.9 (8.6, 23.1), and 8.8±5.2, respectively, which were significantly different with those of 91.7±38.1,16.1 (11.5, 43.3), and 21.9±4.8 in the death group (t=2.186, P=0.034; Z=0.748, P=0.045; t=2.048, P=0.046). The correlation analysis between blood cell count, infection indicators, SII and MELD score showed that white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT) were positively correlated with MELD score (r=0.312, P=0.027; r=0.419, P=0.002; rs=0.507, P<0.001), PLT was negatively correlated with MELD score (r=-0.350, P=0.013), and other indicators were not correlated with MELD score (P>0.05). Conclusion Elevated levels of WBC, NEU, PCT, and decreased levels of PLT are associated with short-term prognosis in HBV-ACLF patients upon admission.

Key words: Immunoinflammatory markers, acute-on-chronic liver failure associated with HBV infection, Prognosis, Correlation