慢性乙型肝炎相关慢加急性肝衰竭患者免疫球蛋白水平与预后的关系

doi:10.3969/j.issn.1671-7171.2023.06.029

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摘要【目的】探讨慢性乙型肝炎(CHB)相关慢加急性肝衰竭(ACLF)患者的近期预后与免疫球蛋白(Ig)水平的关系。【方法】收集本院收治的160例CHB相关ACLF患者的一般资料、临床并发症发生情况和入院时血清IgG、IgM、IgA等实验室检查指标,根据患者入院后3个月内疾病转归情况分为死亡组(63例)和存活组(97例)。绘制受试者工作特征曲线(ROC)评价血清Ig水平预测CHB相关ACLF患者短期预后的效能,采用多因素Logistic回归分析CHB相关ACLF患者短期预后的独立危险因素。【结果】存活组年龄、终末期肝病模型评分、中性粒细胞百分比(NEUT%)、总胆红素和IgG、IgM、IgA水平明显低于死亡组(P<0.05),甲胎蛋白明显高于死亡组(P<0.05)。ROC曲线分析结果显示,IgG、IgM、IgA对CHB相关ACLF患者短期预后均有一定预测效能,曲线下面积分别为0.780、0.746、0.771。多因素Logistic回归分析结果显示,NEUT%、IgG、IgM、IgA是影响CHB相关ACLF患者短期预后的独立危险因素(P<0.05),甲胎蛋白是影响CHB相关ACLF患者短期预后的独立保护因素(P<0.05)。【结论】 IgG、IgM、IgA是潜在的预测CHB相关ACLF患者短期预后的生物标志物,其血清水平升高与CHB相关ACLF患者短期不良预后密切相关。

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	王杰
	张翠翠

关键词 ：乙型肝炎,慢性/并发症, 慢加急性肝功能衰竭/并发症, 免疫球蛋白A, 免疫球蛋白G, 免疫球蛋白M, 预后

Abstract：【Objective】 To study the relationship between short-term prognosis and immunoglobulin (Ig) level in patients with chronic hepatitis B (CHB) with associated chronic acute liver failure (ACLF). 【Methods】 A total of 160 patients with CHB-related ACLF admitted to our hospital were enrolled in the study. The general information,clinical complications and laboratory test indexes of IgG,IgM and IgA at admission were collected. According to the disease outcome within 3 months after admission,patients were divided into the death group (63 cases) and the survival group (97 cases). The efficacy of serum immunoglobulin level in predicting short-term prognosis of patients with CHB-related ACLF was evaluated by receive operating characteristic (ROC),and the independent risk factors for short-term prognosis of patients with CHB-related ACLF were analyzed by multivariate Logistic regression. 【Results】 The age,MELD score,percentage of neutrophil (NEUT%),total bilirubin,IgG,IgM and IgA in the survival group were significantly lower than those in the death group (P<0.05). And alpha-fetoprotein in the survival group was also significantly higher than that in the death group (P<0.05). ROC curve analysis showed that IgG,IgM and IgA had certain predictive valuation for short-term prognosis of CHB-related ACLF patients,and the areas under the curve for IgG,IgM and IgA were 0.780,0.746 and 0.771,respectively. Multivariate Logistic regression analysis showed that the NEUT%,IgG,IgM and IgA were independent risk factors for short-term prognosis inpatients with CHB-related ACLF (P<0.05),while alpha fetoprotein was independent protective factor for short-term prognosis of CHB-related ACLF patients (P<0.05). 【Conclusion】 Levels of IgG,IgM and IgA are potential biomarkers for predicting short-term prognosis in CHB patients:the elevated serum levels are closely associated with poor short-term prognosis in patients with CHB-related ACLF.

Key words： Hepatitis B,Chronic/CO Acute-On-Chronic Liver Failure/CO Immunoglobulin A Immunoglobulin G Immunoglobulin M Prognosis

收稿日期: 2022-06-26

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R512.62

引用本文:

王杰, 张翠翠. 慢性乙型肝炎相关慢加急性肝衰竭患者免疫球蛋白水平与预后的关系[J]. 医学临床研究, 2023, 40(6): 902-905.
WANG Jie, ZHANG Cui-cui. Relationship of Immunoglobulin Level with Prognosis in Patients with Chronic Hepatitis B Complicated with Associated Chronic Acute Liver Failure. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 902-905.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.06.029 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I6/902

[1] ARROYO V,MOREAU R,JALAN R. Acute-on-chronic liver failure[J].N Engl J Med,2020,382(22):2137-2145.
[2] 赵洁,李力,李秀惠,等. 乙型肝炎病毒相关慢加急性肝衰竭患者短期预后模型的建立及预测价值研究[J].中华危重病急救医学,2020,32(8):988-993.
[3] 谭文婷,邓国宏. 肝衰竭前期的发病机制进展[J].中华肝脏病杂志,2020,28(4):302-307.
[4] DONG V,NANCHAL R,KARVELLAS C J. Pathophysiology of acute liver failure[J].Nutr Clin Pract,2020,35(1):24-29.
[5] 中华医学会感染病学分会,中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J].中华传染病杂志,2019,37(12):711-736.
[6] 中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J].中华传染病杂志,2019,37(1):1-9.
[7] 杨红梅,李昱,艾静,等. 可溶性尿激酶型纤溶酶原激活物受体联合甲胎蛋白及终末期肝病模型评分对慢性乙型肝炎相关慢加急性肝衰竭患者近期预后的评估价值[J].中华传染病杂志,2021,39(5):271-275.
[8] LI S,ZHANG X,LI Q,et al. Development and validation of the nomogram based on INR and eGFR for estimation of mortality in patients with acute-on-chronic hepatitis B liver failure[J].BMC Gastroenterol,2021,21(1):474-482.
[9] YANG F,LIU Y,ZENG B,et al. Noninvasive assessment of liver fibrosis for predicting acute-on-chronic liver failure in patients with chronic hepatitis B[J].Hepatol Int,2021,15(3):593-601.
[10] TERGAST T L,SCHUTALBERS M,WEDEMEYER H,et al. IgG,a novel predictor for acute-on-chronic liver failure and survival in patients with decompensated cirrhosis?[J].J Hepatol,2021,75(1):229-231.
[11] 曾然,付松柏,周琳. 免疫球蛋白联合肝功能指标检测在肝衰竭诊断和预后判断中的价值[J].检验医学与临床,2018,15(16):2459-2461.
[12] CHEN D,WEN S,WU Z,et al. Association between effective hepatic blood flow and the severity and prognosis of hepatitis B virus-related acute on chronic liver failure[J].Eur J Gast Hep,2021,32(2):246-254.