The value of alpha fetoprotein and hepatocyte growth factor in evaluating the prognosis of patients with hepatitis B related chronic acute liver failure
Objectives To investigate the value of alpha fetoprotein and hepatocyte growth factor(HGF)in evaluating the prognosis of patients with hepatitis B related chronic acute liver failure.To investigate their value in evaluating the treatment efficacy and prognosis of such patients which was aimed at providing a basis for guiding clinical decision-making to improve patient prognosis.Methods A total of 106 patients with hepatitis B related chronic acute liver failure who were treated in the Infection Department of the Fifth Affiliated Hospital of Xinjiang Medical University from January 2020 to December 2021 were selected as the research objects.According to the admission treatment effect,they were divided into good prognosis group(n=21)and poor prognosis group(n=85).The serum levels of hepatitis B DNA,albumin,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin,creatinine,prothrombin activity(PTA),alpha fetoprotein and HGF were compared between the two groups.Prognosis of hepatitis B related chronic hepatitis patients with acute liver failure were independently predicted by multivariate logistic regression analysis.The receiver operating characteristic(ROC)curve of AFP and HGF predicting the prognosis of hepatitis B related chronic acute liver failure was performed.The net benefit rate of the prognosis hepatitis B related acute on chronic liver failure patients was predicted by AFP and HGF as the ordinate,and the high-risk threshold was abscissa,and the decision curve was drawn.Analyze both and joint prediction model to predict the net benefit rate of the prognosis of hepatitis B related chronic acute liver failure patients.Results Hepatitis B DNA,total bilirubin and creatinine in the poor prognosis group were(7.3±1.3)×106 copies/mL,(187.4±23.3)μmol/L and(178.4±35.3)µmol/L,which were significantly higher than those in the good prognosis group[(4.2±1.1)× 106copies/mL,(167.2±22.4)μmol/L,(142.5±32.6)μmol/L];PTA,alpha fetoprotein and HGF in the poor prognosis group were(23.2±3.1)％,(86.2±13.9)ng/mL and(183.7±28.9)ng/L,respectively,which were significantly lower than those in the good prognosis group[(28.6±3.2)％,(132.3±25.8)ng/mL and(243.5±31.6)ng/L];the above differences were statistically significant(t=3.789,2.018,4.567,2.567,6.712,7.876;all P＜0.05).There were no significant differences in AST,ALT and albumin between two groups(all P＞0.05).Multivariate logistic regression analysis showed that alpha fetoprotein and HGF were independent predictors of prognosis in patients with chronic hepatitis B related acute liver failure(both P＜0.05).ROC analysis showed that the area under the curve(AUC)of alpha fetoprotein in predicting the prognosis of patients with hepatitis B related chronic acute liver failure was 0.803(95％CI:0.775-0.879),the best diagnosis cut-off point was 102.3 ng/mL;AUC of HGF in predicting the prognosis of patients with hepatitis B related chronic acute liver failure was 0.817(95％CI:0.765-0.892),the best diagnosis cut-off point was 1.1 ng/L.The combined prediction value was the highest,AUC was 0.908(95％CI:0.834-0.972).The results of decision curve analysis showed that within the majority of the reasonable threshold probability alpha fetoprotein and HGF had a good net benefit in predicting prognosis for patients with hepatitis B related chronic acute liver failure.Conclusion Alpha fetoprotein and HGF had high value and net profit rate in evaluating the prognosis of patients with hepatitis B related chronic acute liver failure.
Alpha fetoproteinHepatocyte growth factorHepatitis B related chronic acute liver failure
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NSTL
万方数据
