| Ⅰ. Serum thymosinβ4 levels in patients with hepatitis B virus-related liver failure Objective:To detect serum thymosinβ4 values and investigate whether serum thymosinβ4 can provide diagnostic or prognostic information in patients with hepatitis B virus-related liver failureMethod:Serum thymosinβ4 levels were measured in 30 patients with acute-on-chronic liver failure (ACLF),31 patients with chronic liver failure (CLF), 30 patients with compensated liver cirrhosis (CR) and 32 patients with chronic hepatitis B (CHB) and 30 healthy controls. Serum thymosinβ4 levels were measured by enzyme-linked immunosorbent assay (ELISA) and Child-Pugh and model for end-stage liver disease (MELD) scores were calculated for each patient on admission Result:Compared with healthy controls, serum thymosinβ4 levels in ACLF, CLF, CR and chronic hepatitis B patients were significantly lower,6.5047 (4.7879-10.5314)μg/mL vs 0.4632 (0.2759-0.8768)μg/mL,0.6981 (0.5209-1.2008)μg/mL,1.8053 (0.8110-2.3397)μg/mL,3.7803 (1.8570-6.4722)μg/mL, respectively (P<0.001). The levels of thymosinβ4 in liver failure (ACLF or CLF) patients were markedly lower than that in CR (P< 0.001), and a difference was also found between CLF and ACLF patients (P=0.038). In patients with chronic liver disease, there was a positive relationship between thymosinβ4 levels and albumin (ALB), choline esterase (CHE), and platelet(PLT)(P<0.001), and negative relationship with alanine aminotransferase (ALT) (P=0.020), aspartate aminotransferase (AST), total bilirubin (TBIL), international normalized ratio of prothrombin time (INR), and Child-Pugh and MELD scores (P< 0.001). Of the 61 liver failure patients, the thymosinβ4 levels of non-survivor group were significantly lower than that of survivor group(P=0.007). Receiver operating characteristics analysis identified a thymosinβ4 cutoff level of 0.5708μg/mL for predicting poor prognosis in all liver failure patients. The serial thymosinβ4 values were observed in 13 liver failure patients. Lower initial values were observed in the death. While greater improvement in thymosinβ4 value was found in those who recovered from the disease.Conclusion:Serum thymosinβ4 can be used as an important potential diagnostic and prognostic indicator for liver failure.Ⅱ. The predictive value of dynamic changes of serum thymosin B 4 in liver failure patients.Objective:To investigate whether dynamic changes of serum thymosinβ4 can provide prognostic information in liver failure patients. Method:Serum thymosin B4 levels were measured in 81 patients with liver failure (42 patients received artificial liver support system treatment [ALSS group],39 patients received medical treatment [Medical group]).Result:Before treatment, the levels of serum thymosin B4 in the ALSS group 0.5652 (0.3259-0.8650)μg/mL and Medical group 0.6562(0.5134-0.9792)μg/mL, CR group 1.8053 (0.8110-2.3397)μg/mL, CHB group 3.7803 (1.8570-6.4722)μg/mL were significantly lower than Healthy controls 6.5047(4.7879-10.5314)μg/mL (P<0.001, respectively). The level of serum thymosin B4 in ALSS group was also lower than that of Medical group, but the difference between two groups had no statistically significant (P=0.091). The levels of ALT, AST, TBIL, total bile acid (TBA)of ALSS group were more higher than those of Medical group (P<0.05). Other indexes levels of the two groups had no statistically significant difference (P>0.05). Of the 81 liver failure patients, serum thymosinβ4 values of non-survivor group were lower than those of survivor group (P<0.001). In ALSS group, serum thymosin B4 values of non-survivors and survivors had statistically significant difference (P=0.023). Medical group also had the statistically significant difference (P=0.002). But there were no statistical significant when compared survivors of ALSS group and survivor s of Medical group, non-survivors of ALSS group and non-survivors of Medical group (P>0.05). After treatment, serum thymosin B4 levels of survivor group had significant increased (P<0.001). But there was no difference of serum thymosin B4 values of non-survivor group was observed before and after the treatment (P=0.331). Conclusion:Dynamic changes of serum thymosin B4 values can predict the prognosis of patients with liver failure. |
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