Diagnostic value of serum PCT,HBP and pro-ADM in hepatitis B virus-acute-on-chronic liver failure complicated by bacterial infection
Objective To investigate the diagnostic value and prognostic prediction efficacy of serum procalcitonin(PCT),heparin-binding protein(HBP)and pro-adrenomedullin(pro-ADM)in hepatitis B virus-acute-on-chronic liver failure(HBV-ACLF)complicated with bacterial infection.Methods 163 patients with HBV-ACLF who were admitted to the Guizhou Aerospace Hospital from January 2020 to January 2022 were selected,and they were divided into 92 cases in the bacterial infection group and 71 cases in the non-bacterial infection group according to whether they had complicated with bacterial infection,and the bacterial infection group was divided into 49 cases in the death subgroup and 43 cases in the survival subgroup according to the 90 d prognosis.Clinical data were collected from patients,and serum PCT,HBP and pro-ADM levels were measured.Univariate and multivariate logistic regression were used to analyze the correlation between various indicators and the poor prognosis of patients with HBV-ACLF complicated with bacterial infection.The receiver operating characteristic(ROC)curve was used to analyze the value of serum PCT,HBP,pro-ADM levels in diagnosing HBV-ACLF complicated with bacterial infection,and the predictive efficacy of the poor prognosis of patients with HBV-ACLF complicated with bacterial infection.Results Serum PCT,HBP and pro-ADM levels were higher in the bacterially infected group than those in the non-bacterially infected group(U=3.413,3.723,2.878;all P＜0.05).Serum PCT,HBP and pro-ADM levels were higher in the death subgroup than those in the survival subgroup(U=3.665,3.595,3.788;all P＜0.05).Serum PCT,HBP,pro-ADM were strongly associated with poor prognosis in HBV-ACLF patients complicated with bacterial infection(P＜0.05).The area under the curve(AUC)of the combined serum PCT,HBP and pro-ADM levels for the diagnosis of HBV-ACLF complicated by bacterial infection was greater than that of each indicator alone;the AUC of the combined serum PCT,HBP and pro-ADM levels for predicting poor prognosis in patients with HBV-ACLF complicated by bacterial infection was greater than that predicted by each indicator alone and the Child-Pugh score and the model score for end-stage liver disease.Conclusions Increased serum PCT,HBP and pro-ADM levels were closely associated with poor prognosis in patients with HBV-ACLF complicated with bacterial infection.Combined detection of serum PCT,HBP and pro-ADM levels had high diagnostic value and prognostic prediction efficacy in patients with HBV-ACLF complicated with bacterial infection.
Hepatitis B virusAcute-on-chronic liver failureBacterial infectionProcalcitoninHeparin-binding proteinPro-adrenomedullin
NETL
NSTL
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