Abstract: Objective To analyze the correlation of antithrombin III (AT-III) activity with short-term efficacy and prognosis of acute-on-chronic liver failure (ACLF) patients treated with artificial liver support system. Methods A retrospective analysis was performed in 236 ACLF patients treated with artificial liver support system in our hospital from January 1, 2012 to June 30, 2019. The blood routine, liver function, international normalized ratio (INR), and AT-Ⅲ activity were recorded, and the model for end-stage liver disease (MELD) score was calculated at the time of admission. The 30-day efficacy and 90-day survival rate of artificial liver support were evaluated. The t-test and rank sum test were used for measurement data, and the chi-square test was used for count data. The influential factors for the efficacy of artificial liver and patient outcome were analyzed by Logistic regression. Results Artificial liver support was effective in 139 patients, and 63 patients died during the 90-day follow-up. Regression analysis showed that AT-Ⅲ activity (OR=1.118, 95% CI 1.082-1.156, P=0.000) was an independent factor affecting the efficacy of artificial liver. Total bilirubin (OR=1.008, 95% CI 1.004-1.012, P=0.000), INR (OR=1.109, 95% CI 1.076-1.505, P=0.025), AT-Ⅲ activity (OR=0.911, 95% CI 0.881-0.943, P=0.000), and MELD score (OR=1.090, 95% CI 1.052-1.115, P=0.034) were independent factors affecting the 90-day survival of ACLF patients. Conclusion The short-term efficacy of artificial liver support system and short-term prognosis of ACLF was correlated with AT-Ⅲ activity.

Key words: Antithrombin Ⅲ, Liver failure, Artificial liver support system, Efficacy, Prognosis