Abstract: Objective To investigate the expression of serum thyroid hormones in acute on chronic liver failure (ACLF) patients and its correlation with prognosis. Methods Levels of serum free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH) in ACLF patients (n=45) and chronic hepatitis B (CHB) patients (n=49) were detected and their effect on prognosis was analyzed. Results Compared with CHB patients, ACLF patients showed lower levels of FT3 (2.16±0.67 vs. 2.81±0.88, P<0.05) and TSH (0.87±0.82 vs. 2.74±2.33, P<0.05). In ACLF patients, serum TSH level in survivors was significant higher than that in non-survivors (1.12±1.09 vs. 0.58±0.49, P<0.05). Spearman correlation analysis showed that TSH level was negatively correlated with total bilirubin (TBil) and model for end-stage liver disease score (r=0.508 and r=0.467, both P<0.05). Moreover, FT3 was significantly negatively correlated with TBil (r=-0.399, P<0.05). Conclusion Expression of serum thyroid hormones could be an index for severity in ACLF patients and a valuable predictor for ACLF prognosis.

Key words: Thyroid hormones, Acute on chronic liver failure, Prognosis