外周血Th9细胞联合MELD评估失代偿期乙型肝炎肝硬化预后的价值

摘要/Abstract

摘要： 目的探究外周血Th9细胞联合终末期肝病模型(MELD)评估失代偿期乙型肝炎肝硬化(HBC)预后的价值。方法收集海安市人民医院消化科2017年5月至2022年5月收治的107例失代偿期HBC患者的临床资料,根据治疗后6个月内的生存情况分为生存组及死亡组。采用流式细胞仪检测外周血Th9细胞百分率,并进行MELD评估。比较两组患者的一般资料、MELD评分及外周血Th9细胞百分率,logistic回归分析失代偿期HBC预后的影响因素,根据ROC曲线分析外周血Th9细胞百分率联合MELD评分对失代偿期HBC预后的预测价值。结果 107例失代偿期HBC患者治疗后6个月内存活81例,死亡26例。死亡组MELD评分为(23.87±4.16)分,外周血Th9细胞百分率为(3.16±0.34)%,均高于生存组的(16.95±3.35)分和(1.32±0.28)%,差异有统计学意义(P<0.05)。logistic分析显示,MELD评分(OR=3.651,95%CI:1.656~6.001,P<0.01)、外周血Th9细胞百分率(OR=3.846,95%CI:1.691~5.646,P<0.01)为失代偿期HBC预后不良的独立危险因素。经ROC分析显示,MELD评分、外周血Th9细胞百分率评估失代偿期HBC预后的AUC分别为0.744,0.779,95%CI:0.651~0.824,0.688~0.853,联合预测的AUC为0.913(95%CI:0.843~0.959)。结论外周血Th9细胞联合MELD评分对失代偿期HBC预后均有较高的预测价值,可为临床干预提供有效参考。

关键词: 外周血Th9细胞百分率, 终末期肝病模型评分, 失代偿期乙型肝炎肝硬化, 预后

Abstract: Objective To investigate the prognostic value of peripheral blood Th9 cell percentage combined with model of End-stage liver disease (MELD) score for decompensated hepatitis B cirrhosis (HBC).Methods We collected and analyzed clinical data from 107 patients with decompensated HBC admitted to the Gastroenterology Department of Hai 'an People's Hospital between May 2017 and May 2022. Based on their survival condition within 6 months after treatment, the patients were divided into a good prognosis group and a death group. The percentage of Th9 cells in peripheral blood was measured by flow cytometry, and the MELD score was evaluated for all decompensated HBC patients. General data, MELD score and percentage of Th9 cells in peripheral blood were compared between the two groups. Logistic regression analysis was conducted to identify factors influencing the prognosis of decompensated HBC. The ROC curve was used to analyze the predictive value of the combination of peripheral blood Th9 cell percentage and MELD score on the prognosis of decompensated HBC.Results Among the 107 patients with decompensated HBC, 81 survived and 26 died within 6 months after treatment. The MELD score (23.87±4.16) points and the percentage of Th9 cells in peripheral blood (3.16±0.34) % in the death group were higher than those in the survival group [(16.95±3.35) points and (1.32±0.28) % (P<0.05)]. Logistic analysis showed that both the MELD score and the percentage of Th9 cells in peripheral blood were independent risk factors for the poor prognosis of decompensated HBC (OR=3.651, 95% CI: 1.656~6.001, P<0.001; OR=3.846, 95% CI: 1.691~5.646, P<0.001). ROC analysis showed that the AUC values of the MELD score and the percentage of Th9 cells in peripheral blood to evaluate the prognosis of decompensated HBC were 0.744 and 0.779, respectively, with 95% CI from 0.651 to 0.824 and 0.688 to 0.853. When both factors are combined for prediction, the AUC value was 0.913, with a 95% CI of 0.843~0.959.Conclusion The percentage of Th9 cells in peripheral blood combined with MELD score has a high predictive value for the prognosis of decompensated HBC, providing an effective reference for clinical intervention.

Key words: Percentage of Th9 cells in peripheral blood, End-stage liver disease model score, Decompensated hepatitis B cirrhosis, Prognosis

何晓荣, 田尧, 葛桂萍. 外周血Th9细胞联合MELD评估失代偿期乙型肝炎肝硬化预后的价值[J]. 肝脏, 2023, 28(11): 1306-1309.

HE Xiao-rong, TIAN Yao, GE Gui-ping. Prognostic value of peripheral blood Th9 cell percentage combined with MELD score in decompensated hepatitis B cirrhosis[J]. Chinese Hepatolgy, 2023, 28(11): 1306-1309.

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