乙型肝炎病毒相关慢性肝病急性恶化患者急性慢性肝功能衰

StephenW

Medicine (Baltimore). 2018 Aug;97(34):e11915. doi: 10.1097/MD.0000000000011915.
Prediction model of the progression of patients with acute deterioration of hepatitis B virus-related chronic liver disease to acute-on-chronic liver failure.
Li C1, Zhu B, Lv S, You S, Xin S.
Author information

1
    Liver Failure Treatment and Research Center, 302 Military Hospital, Beijing, P.R. China.

Abstract

This study aimed to establish a new model for predicting acute-on-chronic liver failure (ACLF) (defined by the Chinese Medical Association), which potentially occurs among patients with acute deterioration (AD) of hepatitis B virus (HBV)-related chronic liver disease (CLD).A total of 754 patients with AD of HBV-related CLD (total bilirubin (TBIL) > 51.3 μmol/L and prothrombin activity (PTA) < 60%, 40% < PTA < 60% when TBIL ≥ 171.1 μmol/L) were retrospectively analyzed and divided into a training cohort (580 patients) and a validation cohort (174 patients). The ACLF occurrence probability of these patients was statistically analyzed within 4 weeks. In the training cohort, multivariate logistic regression analysis was performed to determine the independent predictors of ACLF occurrence and to develop a new prediction model. The validation cohort was utilized to verify and evaluate the value of the new prediction model.Within 4 weeks, 9.9% of the patients progressed to ACLF (12.0 ± 6.7 days). The new prediction model was characterized by R = 3.090 + 0.035 × Age (years) - 0.050 × PTA (%) + 0.005 × TBIL (μmol/L) + 0.044 × D/T (%) - 0.072 × Na (mmol/L) + 0.180 × HBV DNA (log10IU/mL). The areas under the receiver operating characteristic curves of the training and validation cohorts in the new model were higher than those in the model for end-stage liver disease.The new prediction model could be used by clinicians to recognize patients with AD of HBV-related CLD with high risks of progressing to ACLF.

PMID:
    30142800
DOI:
    10.1097/MD.0000000000011915

StephenW

医学（巴尔的摩）。 2018年8月; 97（34）：e11915。 doi：10.1097 / MD.0000000000011915。
乙型肝炎病毒相关慢性肝病急性恶化患者急性慢性肝功能衰竭预测模型。
李C1，朱斌，吕思，尤思，辛新
作者信息

1
    中国北京302军医院肝功能衰竭治疗研究中心。

抽象

本研究旨在建立预测急性慢性肝功能衰竭（ACLF）的新模型（由中华医学会定义），该模型可能发生在乙型肝炎病毒（HBV）相关慢性病急性恶化（AD）患者中。肝病（CLD）。总共754例ADV与HBV相关的CLD（总胆红素（TBIL）>51.3μmol/ L和凝血酶原活性（PTA）<60％，当TBIL≥171.1时，40％<PTA <60％回顾性分析μmol/ L）并将其分为训练组（580名患者）和验证组（17​​4名患者）。在4周内对这些患者的ACLF发生概率进行统计学分析。在训练组中，进行多变量逻辑回归分析以确定ACLF发生的独立预测因子并开发新的预测模型。验证队列用于验证和评估新预测模型的值。在4周内，9.9％的患者进展为ACLF（12.0±6.7天）。新预测模型的特征是R = 3.090 + 0.035×年龄（年） - 0.050×PTA（％）+ 0.005×TBIL（μmol/ L）+ 0.044×D / T（％） - 0.072×Na（mmol / L） ）+ 0.180×HBV DNA（log10IU / mL）。新模型中训练和验证队列的接受者操作特征曲线下面积高于终末期肝病模型。新的预测模型可供临床医生识别HBV相关AD患者CLD具有进展为ACLF的高风险。

结论：
    30142800
DOI：
    10.1097 / MD.0000000000011915