Abstract:

Objective To investigate the prognostic value of prognostic nutritional index（PNI）in patients with hepatitis B virus related chronic and acute liver failure（HBV⁃ACLF）. Methods Clinical data of 82 patients with non⁃liver transplantation HBV⁃ACLF treated in Nantong Third People′s Hospital from January 2019 to Novem⁃ ber 2021 were collected. They were divided into survival group and death group according to 90⁃day mortality after admission. Risk factors affecting the prognosis of patients were analyzed by binary logistic regression；The clinical efficacy of PNI，MELD score，MELD⁃Na score，iMELD score and PTA were analyzed by ROC curve；The survival curve was drawn by Kaplan Meier method. Results There was no significant difference in sex，age，HBeAg status，complications，artificial liver treatment and HBV⁃DNA between the two groups（P > 0.05）. PNI，albumin， PTA and lymphocytes in the survival group were significantly higher than those in the death group（P < 0.05）. MELD score，MELD Na score and iMELD score in the death group were higher than those in the survival group （P < 0.05），and the difference was statistically significant（P < 0.05）. Multivariate analysis showed that PNI was a prognostic factor in patients with liver failure（P < 0.05）. Pearson correlation analysis showed that PNI was negatively correlated with MELD score，MELD⁃Na score and iMELD score，but positively with PTA（all P < 0.05）. ROC curve analysis showed that the area under the curve of PNI was higher than that of MELD score，MELD Na score，imeld score and PTA. Kaplan Meier analysis showed that the cumulative survival rate of patients in low PNI group was significantly lower than that in high PNI group（P < 0.05）. Conclusion PNI is helpful to evaluate the severity of HBV⁃ACLF patients and is an important parameter for prognosis.

Key words:

hepatitis B, acute?on?chronic liver failure, prognostic nutritional index, progress