Abstract: Objective To explore the predictive value of Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores in combination with serum M30 and M65 levels for the short-term prognosis of patients with hepatitis B-related acute-on-chronic liver failure (HBV-ACLF).Methods One hundred and six HBV-ACLF patients admitted to our hospital from January 2017 to January 2020 were selected in this study. They were divided into a survival group (n=51) and a death group (n=55) according to their 90-day’s prognosis. The general conditions and indicators of laboratory test were compared between the patients in these two groups. Serum M30 and M65 levels were detected and CTP and MELD scores were evaluated. The receiver operating characteristic curve (ROC) was used to analyze the value of CTP and MELD scores, and serum M30 and M65 levels in predicting the short-term prognosis of HBV-ACLF patients.Results The CTP and MELD scores of the death group were (23.02±5.18) points and (31.18±5.89) points, respectively, which were significantly higher than those of (10.49±1.05) points and (13.21±1.34) points of the survival group (P<0.05); the serum levels of M30 and M65 in the death group were (1685.12±413.32) U/L and (2799.41±712.05) U/L, respectively, which were significantly higher than those of (1001.40±316.49) U/L and (1808.85±669.43) U/L of the control group (all P<0.05).The AUC of CTP, MELD, M30, and M65 that individually predicted 90-day mortality were 0.624 (95%CI: 0.525~0.716), 0.804 (95%CI: 0.716~0.875), 0.750 (95%CI: 0.656~0.829), and 0.887 ( 95%CI: 0.810~0.940); The AUC of a combination of these four items was 0.919 (95%CI: 0.850~0.963), which was significantly better than CTP, MELD, M30 in individual evaluation (P<0.05), and higher than M65 individual evaluation but no statistical significant difference (P>0.05).Conclusion CTP and MELD scores and serum M30 and M65 levels can predict the short-term prognosis of patients with HBV-ACLF. The combination of these four items is of better predictive value.

Key words: Hepatitis B virus, Acute-on-chronic liver failure, Child-Turcotte-Pugh, Model for end-stage liver disease, M30, M65