Efficacy of serum HBD-1 and CHI3L1 levels in prognostic assessment of HBV-ACLF
Objective To investigate the efficacy of serum human β-defensin-1(HBD-1)and chitinase-3-like pro-tein 1(CHI3L1)levels in the disease progression and prognostic assessment of hepatitis B virus(HBV)-related acute-on-chronic liver failure(ACLF).Methods A total of 135 HBV-ACLF patients(HBV-ACLF group)were selected,and an-other 60 healthy volunteers(control group)who underwent physical examinations during the same period were selected;HBV-ACLF patients were then divided into the early group(54 cases),middle group(48 cases),and late group(33 cas-es)based on different disease stages;the 28-day disease outcomes were observed.Enzyme linked immunosorbent assay was used to detect serum HBD-1 and CHI3L1 levels.Multivariate Logistic regression analysis was used to identify the fac-tors that affected the prognosis of HBV-ACLF patients.Receiver operating characteristic curve was used to analyze the val-ue of serum HBD-1 and CHI3L1 levels in prognostic assessment of HBV-ACLF patients.Results Compared with the control group,the serum HBD-1 and CHI3L1 levels increased in the HBV-ACLF group(both P<0.05).The levels of se-rum HBD-1 and CHI3L1 increased sequentially in the early group,middle group,and late group(all P<0.05).According to the disease outcome at 28 days,the patients were divided into the death group(55 cases)and survival group(80 cas-es).The 28-day mortality rate of 135 HBV-ACLF patients was 40.74%(55/135).Compared with the survival group,the serum HBD-1 and CHI3L1 levels increased in the death group(both P<0.05).Advanced stage of disease,hepatic en-cephalopathy and neutrophil/lymphocyte count ratio,Child-Turcotte-Pugh score,model for end-stage liver disease(MELD),MELD-sodium score,elevated levels of HBD-1 and CHI3L1 were independent risk factors for mortality in HBV-ACLF patients(all P<0.05),while elevated albumin was independent protective factor(P<0.05).The area under the curve of serum HBD-1 combined with CHI3L1 levels in evaluating the death of HBV-ACLF patients was 0.886,which was larger than 0.779 and 0.786 evaluated by the serum levels of HBD-1 and CHI3L1 alone(both P<0.05).Conclusions The levels of serum HBD-1 and CHI3L1 in HBV-ACLF patients increase,which are closely related to disease progression and poor prognosis.The combined detection of serum HBD-1 and CHI3L1 levels has a high value in evaluating the prognosis of HBV-ACLF patients.
hepatitis B virus-related acute-on-chronic liver failurehuman β-defensin-1chitinase-3-like protein 1disease progressionprognosis
万方数据
维普
