Analysis Of Prognostic Factors For Patients With Acute-on-chronic Hepatitis B Liver Failure

Background and Aim:Acute on-chronic hepatitis B liver failure (ACHBLF) is a serious liver disease with high fatality.Evaluating the patient’s condition and prognosis helps to guide the therapeutic strategy.The aim of this study was to study the clinical values of general conditions, biochemical indexes the model for end-stage liver disease(MELD)and MELD-Na scoring system and the child-Turcotte-Pugh(CTP) scoring system for predicting the short-term prognosis of acute on-chronic hepatitis B liver failure (ACHBLF)Methods:We reviewed patients with ACHBLF diagnosed in our hospital from 2014.6.1 to 2015.12.30.The patients were divided into improved group and deteriorated group.The clinical data were analyzed by using independent-Samples T Test and Binary logistic regression.Results:The factors that significantly affected the prognosis of ACHBLF included age,total bilimbin(TBil),creatinine(Cr),International Normalized ratio (INR), prothrombin time(PT), white blood cell counts (WBC),blood platelet count (PLT), serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST),alpha fetoprotein(AFP), hepatic encephalopathy, infection, hyponatremias (P<0.05) Infection,hepatic encephalopathy, hyponatremias, INR, ALT, AST, WBC, PLT were independent risk factors of prognosis.The mean MELD,MELD-Na and CTP Score of the death group was significantly higher than that of the survival group (P<0.05).The areas under the curve of the MELD、MELD-Na and CTP scores were 0.759,0.746 and 0.609.Conclusion:Infection,hepatic encephalopathy, hyponatremias,INR,ALT,AST,WBC, PLT are important to assess the prognosis of ACHBLF and may be useful to guide clinical treatment.The MELD and MELD-Na scoring system is slightly superior to the CTP scoring system for predicting short-term prognosis of ACHBLF.