关键词:

乙型肝炎病毒, 慢加急性肝衰竭, 髓样细胞触发受体2, 终末期肝病模型, 预后

Abstract:

Objective To investigate the energy efficiency of plasma triggering receptor expressed on my⁃eloid cell 2（TREM⁃2）combined with model for end⁃stage liver disease（MELD）score in predicting the near⁃termprognosis of patients with hepatitis B virus⁃acute⁃on⁃chronic liver failure（HBV⁃ACLF）. Methods A total of 142patients with HBV⁃ACLF admitted to our hospital from January 2019 to January 2021 were selected as the HBV⁃ACLF group，and were divided into a death group（n = 52）and a survival group（n = 90）according to patientoutcomes at 90 d follow⁃up，and another 58 physically healthy individuals were selected as the control group duringthe same period. Plasma interleukin ⁃ 6（IL ⁃6），IL8，and TREM ⁃2 levels were measured by ELISA and MELDscores were calculated. Pearson/Spearman correlation coefficient was used to analyze the correlation between plasmaTREM⁃2 and the levels of IL⁃6 and IL⁃8 in HBV⁃ACLF patients. Multivariate logistic regression was used to analyzefactors influencing the poor prognosis of HBV ⁃ACLF patients in the near future. The predictive value of plasmaTREM⁃2 levels combined with the MELD score for the near⁃term prognosis of HBV⁃ACLF patients was analyzedusing ROC curves. Results Plasma IL⁃6，IL⁃8 and TREM⁃2 levels were significantly elevated in the HBV⁃ACLFgroup compared to the control group（P < 0.05）. Plasma TREM⁃2 was positively correlated with the levels of IL⁃6and IL⁃8 in HBV⁃ACLF patients（r/rs = 0.762，0.857，all P < 0.001）. Neutrophil ratio，total bilirubin，bloodcreatinine，international normalized ratio，MELD score，IL⁃6，IL⁃8 and TREM⁃2 were independent risk factors forpoor prognosis of the HBV⁃ACLF patients in the near future（P < 0.05）.The areas under the curve for the TREM⁃2，MELD score，and TREM ⁃ 2 + MELD score predicting the near ⁃term prognosis of the HBV ⁃ACLF patients were 0.771，0.795，and 0.858，respectively，and the area under the curve for the TREM ⁃2 + MELD score predictingthe near ⁃ term prognosis of HBV ⁃ ACLF patients was significantly greater than that predicted by the TREM ⁃ 2，MELD score alone（P < 0.05）. Conclusion Plasma TREM⁃2 levels and elevated MELD scores are independentrisk factors for poor prognosis of HBV ⁃ ACLF patients in the near future，and plasma TREM ⁃ 2 combined withMELD scores enhances the predictive value of poor prognosis of the patients in the near future.

Key words:

hepatitis B virus, acute?on?chronic liver failure, triggering receptor expressed on myeloid cell 2, model for dnd?stage liver disease, prognosis