Changes of serum alkaline phosphatase in patients with HBV-related acute-on-chronic liver failure and its significance

Abstract

Abstract: Objective To investigate the changes of serum alkaline phosphatase (ALP) in patients with hepatitis B virus (HBV)- related acute-on-chronic liver failure (HBV-ACLF) and its significance.Methods A total of 92 HBV-ACLF patients hospitalized in our hospital from January 2015 to December 2018 were enrolled in the study, as well as 40 patients with chronic hepatitis B (CHB) and 34 healthy controls. ALP levels in peripheral blood of the 3 groups were compared. Differences of the dynamic changes in ALP levels from admission to 1 week after admission were studied. In HBV-ACLF patients, survival rates between increasing ALP group and decreasing ALP group were compared. The associations of the increase of ALP with pre-albumin level and model for end-stage liver disease (MELD) score were analyzed. Results The ALP levels of HBV-ACLF group, CHB group and control group were (421.37 ± 136.35), (116.14 ± 38.62) and (104.23 ± 35.19) U/L, respectively, and the differences among groups were significant (F=77.193, P<0.05). The ALP level of HBV-ACLF group was significantly higher than that of CHB group and control group (Q=3.704 and 4.548, respectively, P<0.05 for both). In HBV-ACLF patients, the increase of ALP of survival subgroup was significantly higher than that of death subgroup, and the difference was statistically significant [(86.17 ± 19.36) vs (29.46 ± 8.21) U/L, t=4.78, P<0.05]. The survival rate of increasing ALP subgroup was higher than that of decreasing ALP subgroup, and the difference was statistically significant (73.08% vs 32.5%, χ² = 33.48, P<0.05). One week after admission, the MELD score of patients with HBV-ACLF was (35.63 ± 5.81), and the pre-albumin level was (73.57 ± 32.69) g/L. The increase of ALP was negatively correlated with MELD score, and positively correlated with pre-albumin level (r=-0.725 and 0.763, respectively, P<0.05 for both).Conclusion The continuous increase of peripheral blood ALP in patients with HBV-ACLF is a predictor of good prognosis.

Key words: Liver failure, Hepatitis B virus, Alkaline phosphatase, Pre-albumin, Model for end-stage liver disease

GU Jing, CHEN Zu-tao, SUN Wei, GAN Jian-he. Changes of serum alkaline phosphatase in patients with HBV-related acute-on-chronic liver failure and its significance[J]. Chinese Hepatolgy, 2019, 24(11): 1234-1236.

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