肝再生增强因子在HBV相关慢加急性肝功能衰竭中的水平变化及意义

The expression and clinical significance of augmenter of liver regeneration in patients with HBV related acute on chronic liver failure

目的研究肝再生增强因子(ALR)在HBV相关慢加急性肝功能衰竭(ACLF)中的水平变化及临床意义。方法病例来源于该科门诊及住院的慢性乙型肝炎患者,包括ACLF组(n=214)和慢性乙型肝炎轻度组(n=196);对照组(n=200)来源于输血科健康献血者。采用ELISA法检测各组对象血清ALR水平,分析ACLF组ALR水平与患者终末期肝病模型(MELD)评分关系。单因素非条件Logistic回归分析ALR水平与ACLF患者预后的相关性。结果 ACLF组ALR水平明显高于慢性乙型肝炎轻度组和对照组(P<0.01)。ACLF患者ALR水平与MELD评分呈负相关(r2=-0.249,F=13.955,P<0.01)。ACLF患者生存组ALR水平明显高于死亡组(P=0.004)。单因素非条件Logistic回归分析表明ALR水平与ACLF患者24周预后相关,高水平ALR患者预后较好(P=0.012,OR=0.807)。结论 HBV相关ACLF患者ALR水平明显升高,有利于肝细胞再生,可以作为评价患者预后指标。

Objective To investigate the expression and clinical significance of augmenter of liver regeneration （ALR） in patients with HBV related acute on chronic liver failure （ACLF） .Methods The serum and clinical data of patients with ACLF （ACLF group ,n=214） ,patients with mild chronic hepatitis B （mild chronic hepatitis B group ,n=196） were collected from outpatient and inpatient in the hospital ,and control group（n=200） people were the blood transfusion healthy blood donors .The level of ALR was measured by ELISA method .The correlation between ALR and MELD score of patients with ACLF were analyzed by linear regres-sion analysis .Unconditioned binary response logistic regression model was used to determine the correlation between ALR and mor-tality at 24 weeks of patients with ACLF .Results Serum ALR level was higher in ACLF group than in mild chronic hepatitis B group and control group（P〈0 .05） .There were negative correlations between the serum ALR level and MELD score of patients with ACLF（r2 = -0 .249 ,F=13 .955 ,P〈0 .01） .Serum ALR level of patients with ACLF was more significant in survival group than in dead group（P=0 .004） .Logistic regression analysis identified that high serum ALR level was related to the good prognosis （P=0 .012 ,OR=0 .807） .Conclusion The serum ALR level was significantly increased in patients with HBV related ACLF which played an important role in liver regeneration and improve the prognosis of patients .