The Research Of MPV With Poor Short-term Outcomes In HBV-ACLF Patients

Objective:Mean platelet volume(MPV) as a biological indicator of platelet activation, can be used in the assessment of platelet function. In general, larger platelets are more metabolically and enzymatically more active than those smaller size. It has been shown that MPV can be used as a prognostic biomarker in some chronic diseases. The aim of the present study is to investigate the possible association between MPV and clinical outcome and prognosis in patients with HBV-related acute-on-chronic liver failure(HBV-ACLF) within 4 weeks.Methods:64 patients with HBV-ACLF, 19 chronic hepatitis B(CHB) patients, 27 patients with hepatitis B-related cirrhosis(CR, Child-Pugh A/B), 51 healthy subjects(healthy controls, HC) were enrolled in this study. All patients were admitted to the Department of Hepatology, The Third Central Clinical College of Tianjin Medical University from April 2010 to January 2014. After 12 h of fasting, we collected and analyzed the patients’ general information(age, gender), conventional laboratory examination(platelet count, mean platelet volume, creatinine, glucose), liver function(alanine aminotransferase, aspartate aminotransferase, albumin, international normalized ratio), hepatitis B virus indicators(deoxyribonucleic acid, Hepatitis B surface antigen) as well as HBV-related complication( hepatic encephalopathy, ascites, spontaneous bacterial peritonitis). In the ACLF group, the relationships between the prognosis and the MPV values were analyzed.Results:1. At baseline, a statistically significant increase in MPV was shown in patients with ACLF(median 9.5, range 7.1-14.1) compared with HC( 8.0, 7.2-11.9, P < 0.001), CR(8.4, 5.9-11.1, P < 0.001) and CHB(8.3, 7.3-12.0, P < 0.001).2. The MPV value was positively correlated with model of end stage liver disease(MELD) score(r = 0.335, P = 0.007)and international normalized ratio(INR)(r = 0.2250; P = 0.046).3. In HBV-ACLF group, the MPV level was significantly increased in nonsurvivors(median 10.6,range 9.0- 14.1) than survivors(9.3, 7.1- 11.9), P = 0.003. Multivariate logistic regression analysis showed that only MPV level was independent factor predicting poor short-term outcomes.4. In HBV-ACLF group, high MPV level showed a significantly lower survival rate(P = 0.001), MPV level in combination with MELD score may assist prediction of disease progression and prognosis in patients with HBV-ACLF within 4 weeks.Conclusions:Patients with HBV-ACLF have higher MPV. To some existence, it may be used as a predictor for 4-week mortality rate in patients with HBV-ACLF,and MPV level in combination with MELD score may be more effective in prediction of disease progression and prognosis in patients with HBV-ACLF within 4 weeks.