Zhang Xiaoman, He Jingjing, He Xiangping, Lun Yongzhi, He Caiting, Xu Zhengju
Department of Laboratory Medicine, School of Health; Key Laboratory of Screening and Control of Infectious Diseases, Fujian Provincial University, Quanzhou Medical College, Quanzhou, Fujian, China.
Infection Department, the 910th Hospital of the PLA Logistics Support Force, Quanzhou, Fujian, China.
Sci Rep. 2025 Jul 1;15(1):22191. doi: 10.1038/s41598-025-06472-1.
To analyze the predictive value of serum Golgi protein 73 (GP73) and IL-6 for 90-day prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). A total of 289 patients with hepatitis B virus infection who attended the Infection Department of the 910th Hospital of the PLA Logistics Support Force from February 2022 to April 2024 were included in this study. A total of 149 patients with HBV-ACLF were followed up for 3 months after diagnosis, and their outcomes were recorded and assessed. Serum GP73 and IL-6 levels were determined via an enzyme-linked immunosorbent assay and an automatic electrochemical luminescence immunity analyzer, respectively. Multivariate Cox regression, piecewise linear regression analysis, threshold effect and receiver operating characteristic curves were used to evaluate the predictive value of serum Golgi protein 73 (GP73) and IL-6 for 90-day prognosis in patients with HBV-ACLF. Our results revealed that the serum GP73 and IL-6 levels in patients with HBV-ACLF were significantly higher than in chronic hepatitis B group (all P values < 0.001). The serum levels of GP73 and IL-6 in patients with HBV-ACLF who survived after 90 days were lower than those in the nonsurvival group (all P values < 0.001). In addition, the highest serum levels of GP73 and IL-6 were associated with a greater risk of death in HBV-ACLF patients after adjusting for potential confounders (P = 0.0094, 0.0377). Additionally, a nonlinear relationship was observed between GP73 and the risk of 90-day mortality, with an inflection point at 298.99 ng/mL (P = 0.003). A positive linear correlation between IL-6 and the risk of 90-day death was observed in patients with serum IL-6 levels less than 98.78 pg/mL (P = 0.0368). Furthermore, the accuracy of classical prognostic scores, including the model for end-stage liver disease (MELD) score and model for end-stage liver disease-sodium (MELD-Na) score, was significantly improved after combining GP73 and IL-6 in predicting the 90-day prognosis of patients with HBV-ACLF. Serum GP73 and IL-6 levels were significant predictors of short-term prognosis in patients with HBV-ACLF. The combination of GP73 and IL-6 significantly improved the predictive value of classical prognostic scores.
分析血清高尔基体蛋白73（GP73）和白细胞介素-6（IL-6）对乙型肝炎病毒相关慢加急性肝衰竭（HBV-ACLF）患者90天预后的预测价值。本研究纳入了2022年2月至2024年4月在解放军联勤保障部队第910医院感染科就诊的289例乙型肝炎病毒感染患者。共对149例HBV-ACLF患者进行了诊断后3个月的随访，并记录和评估了他们的结局。分别通过酶联免疫吸附测定和全自动电化学发光免疫分析仪测定血清GP73和IL-6水平。采用多因素Cox回归、分段线性回归分析、阈值效应和受试者工作特征曲线来评估血清高尔基体蛋白73（GP73）和IL-6对HBV-ACLF患者90天预后的预测价值。我们的结果显示，HBV-ACLF患者的血清GP73和IL-6水平显著高于慢性乙型肝炎组（所有P值均<0.001）。90天后存活的HBV-ACLF患者的血清GP73和IL-6水平低于未存活组（所有P值均<0.001）。此外，在调整潜在混杂因素后，血清GP73和IL-6的最高水平与HBV-ACLF患者更高的死亡风险相关（P = 0.0094，0.0377）。此外，观察到GP73与90天死亡风险之间存在非线性关系，拐点为298.99 ng/mL（P = 0.003）。在血清IL-6水平低于98.78 pg/mL的患者中，观察到IL-6与90天死亡风险呈正线性相关（P = 0.0368）。此外，在预测HBV-ACLF患者的90天预后时，将GP73和IL-6联合使用后，包括终末期肝病模型（MELD）评分和终末期肝病-钠模型（MELD-Na）评分在内的经典预后评分的准确性显著提高。血清GP73和IL-6水平是HBV-ACLF患者短期预后的重要预测指标。GP73和IL-6的联合使用显著提高了经典预后评分的预测价值。
