CLIF-SOFA评分对HBV-ACLF患者器官衰竭的评估价值

摘要/Abstract

摘要： 目的探讨慢性肝衰竭-序贯器官功能评分(CLIF-SOFA)对乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)患者器官衰竭的评估价值。方法纳入连云港市第一人民医院2016年8月至2019年8月收治的HBV-ACLF患者100例, 根据患者的器官衰竭情况, 分成器官衰竭组、无器官衰竭组。比较两组CLIF-SOFA评分, 绘制受试者工作特征曲线(ROC)分析CLIF-SOFA评分对器官衰竭的预测价值。经Pearson线性相关分析CLIF-SOFA评分与各血清指标的相关性。结果 100例HBV-ACLF患者中, 有21例未见器官衰竭, 79例出现器官衰竭。器官衰竭组CLIF-SOFA评分为(6.19±1.04)分显著高于无器官衰竭组的(4.17±1.01)分(P<0.05)。CLIF-SOFA评分预测器官衰竭的曲线下面积为0.808(标准误=0.053, P=0.000, 95%CI=0.705～0.911)。器官衰竭组血清TBil、WBC为(384.64±15.89)μmol/L、(7.94±1.56)×10⁹/L, 较无器官衰竭组[(189.48±17.84)μmol/L、(6.21±1.75)×10⁹/L]明显增高, 器官衰竭组TC、ALT、AST为(1.76±0.34)mmol/L、(384.50±96.76)U/L、(328.91±91.12)U/L, 较无器官衰竭组[(2.32±0.83)mmol/L、(645.41±124.64)U/L、(552.32±114.76)U/L]显著下降(P<0.05)。HBV-ACLF器官衰竭患者的CLIF-SOFA评分与血清TBil、WBC呈正相关(r=0.616、0.824, P<0.05), 与ALT、AST呈负相关(r=-0.742、-0.574, P<0.05)。结论 CLIF-SOFA评分能对HBV-ACLF患者器官衰竭进行预测, 其与患者血清TBil、WBC、ALT、AST有相关性。

关键词: 慢性肝衰竭-序贯器官功能评分, 乙型肝炎病毒, 慢加急性肝衰竭, 器官衰竭

Abstract: Objective To investigate the value of chronic liver failure sequential organ failure assessment (CLIF-SOFA) score in predicting organ failure in patients with hepatitis B virus associated acute-on-chronic liver failure (HBV-ACLF).Methods A total of 100 HBV-ACLF patients admitted to our hospital from August 2016 to August 2019 were divided into organ failure group and non-organ failure group according to the condition of organ involvement. The CLIF-SOFA scores were compared between the 2 groups. The receiver operator characteristic (ROC) curve was used to analyze the predictive value of CLIF-SOFA scores for organ failure. On the day of admission, 2 mL of fasting venous blood was collected. The levels of total bilirubin (TBil), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alpha fetoprotein (AFP) and leukocyte count (WBC) were measured. Correlation between CLIF-SOFA score and serum indexes were analyzed by Pearson correlation coefficient.Results Of the 100 cases, 21 (21.00%) had no organ failure and 79 (79.00%) had organ failure. The organ failure group had higher CLIF-SOFA score (6.19±1.04) than the non-organ failure group (4.17±1.01) (P<0.05). The area under the ROC curve of CLIF-SOFA score was 0.808 (standard error = 0.053, P=0.000, 95% confidence interval = 0.705-0.911). Serum TBil and WBC in organ failure group [(384.64±15.89) μmol/L, (7.94±1.56) × 10⁹/L] were significantly higher than those in non-organ failure group [(189.48±17.84) μmol/L, (6.21±1.75) × 10⁹/L] (P<0.05). TC, ALT and AST in organ failure group [(1.76±0.34) mmol/L, (384.50±96.76) U/L, (328.91±91.12) U/L] were significantly lower than those in non-organ failure group [(2.32±0.83) mmol/L , (645.41±124.64) U/L, (552.32±114.76) U/L] (P<0.05). The CLIF-SOFA score of HBV-ACLF patients with organ failure was positively correlated with serum TBil and WBC (r=0.616, 0.824, P<0.05), and negatively correlated with ALT and AST (r=-0.742, -0.574, P<0.05).Conclusion CLIF-SOFA score can predict organ failure in patients with HBV-ACLF, which is related to TBil, WBC, ALT and AST.

Key words: Chronic liver failure sequential organ failure assessment, Hepatitis B virus, Acute-on- chronic liver failure, Organ failure

马皖苏, 赵林, 李红生. CLIF-SOFA评分对HBV-ACLF患者器官衰竭的评估价值[J]. 肝脏, 2020, 25(6): 578-581.

MA Wan-su, ZHAO Lin, LI Hong-sheng. Predictive value of CLIF-SOFA score for organ failure in patients with HBV-ACLF[J]. Chinese Hepatolgy, 2020, 25(6): 578-581.

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