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低前白蛋白水平与乙型肝炎病毒(HBV)相关失代偿性肝硬化肝性脑病的发生频率增加相关。

Low Prealbumin Levels Were Associated with Increased Frequency of Hepatic Encephalopathy in Hepatitis B Virus (HBV)-Related Decompensated Cirrhosis.

机构信息

Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu, Sichuan, China (mainland).

College of Medicine, Southwest JiaoTong University, Chengdu, Sichuan, China (mainland).

出版信息

Med Sci Monit. 2023 Apr 20;29:e937772. doi: 10.12659/MSM.937772.

Abstract

BACKGROUND The role of nutritional parameter prealbumin in predicting the incidence of hepatic encephalopathy (HE) remains unclear. This study was designed to assess the diagnostic performance of prealbumin in predicting the incidence of HE in hepatitis B virus (HBV)-related decompensated liver cirrhosis patients. MATERIAL AND METHODS A retrospective cohort of 262 patients with HBV-related decompensated liver cirrhosis was involved in this study. Prealbumin, albumin, and other indicators were collected at admission, and independent factors were identified by logistic regression analysis. The Mann-Whitney U test and receiver operating characteristic (ROC) curves were used to compare the groups and indicators. RESULTS A total of 262 patients were enrolled in the study, including 197 men and 65 women. In patients with HBV-related decompensated liver cirrhosis accompanied by HE, the model for end-stage liver disease (MELD) scores, and prothrombin time (PT) and international normalized ratio (INR) values were significantly increased, while prealbumin and albumin levels were significantly decreased. Multivariate analysis showed that only serum prealbumin level (P=0.014) was independently related to the incidence of HE. Moreover, prealbumin level was negatively correlated with MELD (r=-0.63, P<0.001) and Child-Turcotte-Pugh (r=-0.35, P<0.001) scores. ROC curves were performed, and prealbumin showed the highest area under the ROC curve (0.781) compared with MELD and Child-Turcotte-Pugh scores. CONCLUSIONS Low prealbumin levels were associated with increased frequency of hepatic encephalopathy in HBV-related decompensated cirrhosis, which showed better performance than traditional models.

摘要

背景

前白蛋白在预测肝性脑病(HE)发生率中的作用尚不清楚。本研究旨在评估前白蛋白在预测乙型肝炎病毒(HBV)相关失代偿性肝硬化患者发生 HE 中的诊断性能。

材料与方法

本研究纳入了 262 例 HBV 相关失代偿性肝硬化患者。入院时收集前白蛋白、白蛋白和其他指标,采用 logistic 回归分析确定独立因素。采用 Mann-Whitney U 检验和受试者工作特征(ROC)曲线比较组间和指标。

结果

共纳入 262 例患者,其中男 197 例,女 65 例。HBV 相关失代偿性肝硬化伴 HE 患者的终末期肝病模型(MELD)评分、凝血酶原时间(PT)和国际标准化比值(INR)显著升高,而前白蛋白和白蛋白水平显著降低。多因素分析显示,只有血清前白蛋白水平(P=0.014)与 HE 的发生独立相关。此外,前白蛋白水平与 MELD(r=-0.63,P<0.001)和 Child-Turcotte-Pugh(r=-0.35,P<0.001)评分呈负相关。进行 ROC 曲线分析,前白蛋白的 ROC 曲线下面积(AUC)最高(0.781),优于 MELD 和 Child-Turcotte-Pugh 评分。

结论

低前白蛋白水平与 HBV 相关失代偿性肝硬化患者肝性脑病的发生频率增加相关,其性能优于传统模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4671/10127547/caa21b561cbd/medscimonit-29-e937772-g001.jpg

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