Abstract：【Objective】To explore the application value of the ratio of total bile acid (TBA) to high-density lipoprotein cholesterol (HDL-C) (TBA/HDL-C) combined with cystatin C (cys C) in evaluating the short-term prognosis of patients with acute-on-chronic liver failure (ACLF). 【Methods】The clinical data of 87 ACLF patients admitted to our hospital from January 2021 to October 2023 were retrospectively analyzed. According to the survival status, the patients were divided into the survival group (n=38) and the death group (n=49). General information of the patients was collected, and the levels of TBA, HDL-C and cys C at admission were recorded, with TBA/HDL-C calculated. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of TBA/HDL-C and cys C in predicting the short-term prognosis of ACLF patients. Kappa consistency test was used to analyze the consistency between the prediction of short-term prognosis by TBA/HDL-C, cys C and the actual prognosis. 【Results】The serum levels of HDL-C and TBA in the survival group were higher than those in the death group, while the levels of TBA/HDL-C and cys C were lower than those in the death group, with statistically significant differences (P<0.05). The Kappa values of TBA/HDL-C, cys C, and their combination in predicting short-term prognosis compared with actual prognosis were 0.609, 0.626, and 0.716, respectively. The combination showed a higher degree of consistency with the actual prognosis. TBA/HDL-C and cys C had high sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in predicting the short-term prognosis of ACLF, and their combination showed better predictive performance, especially in sensitivity and negative predictive value. ROC curve analysis showed that both TBA/HDL-C and cys C alone had good predictive efficacy, and the area under the curve (AUC) of their combination was 0.854, which was superior to either of them alone (P<0.05).【Conclusion】The combination of TBA/HDL-C and cys C can effectively predict the short-term prognosis of ACLF patients, and has important reference value for clinical treatment and prognosis evaluation of patients.
王慧卿, 李惠, 刘贝贝. TBA/HDL-C、cys C在ACLF患者短期预后评估中的应用价值[J]. 医学临床研究, 2025, 42(7): 1216-1219.
WANG Huiqing, LI Hui, LIU Beibei. Application Value of TBA/HDL-C and cys C in Short-Term Prognosis Evaluation of Patients with ACLF. JOURNAL OF CLINICAL RESEARCH, 2025, 42(7): 1216-1219.
2025, Vol. 42 
