Center for Liver Diseases, The First Affiliated Hospital, Fujian Medicine University , Fuzhou, Fujian Province, China.
Expert Rev Gastroenterol Hepatol. 2020 Jun;14(6):483-489. doi: 10.1080/17474124.2020.1763172. Epub 2020 May 20.
Acute-on-chronic liver failure due to hepatitis B virus infection is a subtype of liver failure. The aim of the current study was to investigate the clinical significance of serum lactic acid in combination with the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFA) for evaluating the short-term prognosis of HBV-related ACLF patients.
The serum lactic acid level, the score model for end-stage liver disease (MELD), as well as the CLIF-SOFA of inpatients with HBV-related ACLF who were admitted to the Liver Disease Center of the First Affiliated Hospital of Fujian Medical University between 2009 and 2017 were analyzed.
Three hundred and ninety-one HBV-related ACLF inpatients were measured. In the survival group, the lactate clearance rate measured over the course of 1 week post-admission was significantly higher than that measured for the death group. The area under the curve (AUC) for predicting the prognosis of HBV-related ACLF patients in short-term (within 3-month) with a baseline lactic acid level was 0.776.
Prediction performance of the short-term prognosis of HBV-related ACLF patients by combining the lactic acid level into the CLIF-SOFA score was significantly improved in comparison to using the CLIF-SOFA score alone.
乙型肝炎病毒感染导致的慢加急性肝衰竭是肝衰竭的一个亚型。本研究旨在探讨血清乳酸联合慢性肝脏衰竭序贯器官衰竭评估评分（CLIF-SOFA）对乙型肝炎相关慢加急性肝衰竭患者短期预后的评估价值。
分析了 2009 年至 2017 年期间福建医科大学附属第一医院肝病中心收治的乙型肝炎相关慢加急性肝衰竭住院患者的血清乳酸水平、终末期肝病模型（MELD）评分和 CLIF-SOFA。
共测量了 391 例乙型肝炎相关慢加急性肝衰竭住院患者。在存活组中，入院后 1 周内乳酸清除率明显高于死亡组。基线乳酸水平预测乙型肝炎相关慢加急性肝衰竭患者短期（3 个月内）预后的曲线下面积（AUC）为 0.776。
与单独使用 CLIF-SOFA 评分相比，将乳酸水平纳入 CLIF-SOFA 评分可显著提高乙型肝炎相关慢加急性肝衰竭患者短期预后的预测性能。
