摘要
目的探讨IL-33和可溶性生长刺激表达基因2蛋白(sST2)联合终末期肝病模型(MELD)评分对乙型肝炎相关慢加急性(亚急性)肝衰竭(HBV-ACLF)患者短期预后的预测价值。方法检测HBV-ACLF患者59例(观察组)和健康志愿者30例(对照组)生化指标、IL-33和sST2,计算MELD评分。根据HBV-ACLF患者入院后第12周的病情分为好转组31例及恶化组28例,比较两组相关指标,采用二元logistic回归分析HBV-ACLF患者短期预后的影响因素,采用ROC曲线评估IL-33、sST2及MELD评分对HBV-ACLF患者短期预后的预测价值。结果与对照组比较,观察组TBil、国际标准化比值(INR)、凝血酶原时间(PT)、空腹血糖、IL-33、sST2和MELD评分升高(P<0.05),好转组PT、INR、IL-33、sST2、TBil和MELD评分较恶化组降低(P<0.05)。高水平IL-33和sST2以及高MELD评分是HBV-ACLF患者短期预后的独立危险因素(P<0.05)。ROC曲线分析显示,MELD评分、IL-33和sST2预测HBV-ACLF患者短期预后的AUC分别为0.816、0.810和0.729,IL-33+sST2和IL-33+sST2+MELD评分预测预后的AUC分别为0.847和0.851。取IL-33+sST2+MELD评分的最佳截断值为0.491时,其预测HBV-ACLF患者预后的灵敏度为0.786,特异度为0.839。结论IL-33和sST2对HBV-ACLF患者短期预后有较好的预测价值,其联合MLED评分的预测效果更好。
Objective To investigate the value of IL-33 and soluble growth stimulation expressed gene 2(sST2)combined with model for end-stage liver diseases(MELD)score in predicting short-term prognosis of the patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods The biochemical indexes,IL-33 and sST2 were detected in 59 HBVACLF patients(group A)and 30 healthy people(group B).MELD score was calculated.The HBVACLF patients were divided into two groups of A1(getting better)and A2(getting exacerbated)according to the illness status in the 12 t h week after admission.The indicators were compared between the two groups.The influencing factors for the short-term prognosis of the patients with HBV-ACLF were analyzed.The predictive values of IL-33,sST2 and MELD score were anaylzed by ROC curve.Results Compared to group B,the TBil,international normalized ratio(INR),prothrombin time(PT),fasting blood glucose,IL-33,sST2 and MELD score were higher in group A(P<0.05).The PT,INR,IL-33,sST2,TBil and MELD score were lower in group A1 than those in group A2(P<0.05).The higher levels of IL-33,sST2 and MELD score were the risk factors for the short-term prognosis of the patients with HBV-ACLF(P<0.05).ROC curve analysis showed that the AUC of MELD score,IL-33 and sST2 in predicting the short-term prognosis of HBV-ACLF patients were0.816,0.810 and 0.729,respectively.The AUC of IL-33+sST2 and IL-33+sST2+MELD score in predicting the short-term prognosis were 0.847 and 0.851,respectively.When the cut-off value of IL-33+sST2+MELD score was 0.491,the sensitivity and specificity of predicting the prognosis of HBV-ACLF patients were 0.786 and 0.839,respectively.Conclusion IL-33 and sST2 have higher predictive value for the short-term prognosis of the patients with HBV-ACLF,which combined with MLED score have better predictive efficiency.
作者
明芳
章颖
李兆明
刘先进
薛红
MING Fang;ZHANG Ying;LI Zhaoming(Department of Intensive Infectious Diseases,Affiliated Nantong Third Hospital,Nantong University,Nantong 226001,CHINA)
出处
《江苏医药》
CAS
2022年第2期186-190,共5页
Jiangsu Medical Journal
基金
南通市市级科技计划项目(MSZ18196)
南通市市级科技计划项目(MSZ20099)。
