Predictive Value Of Soluble CD163 (sCD163) In The Paitents Of Acute-on-chronic Hepatitis B Liver Failure With Artificial Liver Therapy

BackgroundLiver failure is a common syndrome of severe liver diseases with extremely high rate of mortality. In China, the main cause of liver failure is viral hepatitis (mainly hepatitis B virus). Artificial liver support system is an effective method of treatment of liver failure, its clinical application has greatly reduced the mortality of liver failure. CD 163 is mononuclear-macrophage specific protein with two forms, membrane form and soluble form, and it is also associated with inflammatory. Early research of our team has shown that soluble CD 163 (sCD163) was significantly high in the patients with liver failure. Related studies show that the expression of sCD163 may reflect the severity and prognosis of patients with liver failure. So far, there has not been related study of sCD163 in the patients of liver failure with artificial liver therapy.AimTo assess soluble cluster of differentiation 163 (sCD163) expression in plasma and analyze its association with diseases in the patients of acute-on-chronic hepatitis B liver failure (ACHBLF) with artificial liver therapy.MethodsA retrospective study was conducted from December 1,2011 to December 1,2012 in the First Affiliated Hospital of Zhejiang University. Thirty-one patients of ACHBLF with artificial liver therapy (three times or more) were divided into non-survival group (n=18) and survival group (n=13) according to the prognosis of the patients. Soluble CD 163 levels were measured by enzyme linked immunosorbent assay (ELISA). Clinical variables were also recorded. Comparisons of sCD163, total bilirubin (TBil), international normalized ratio (INR) and prothrombin time activity (PTA) between groups were analyzed by T test or U test. Statistical analyses were performed using SPSS 20.0 software and a P value< 0.05 was considered statistically significant.ResultsSignificant increase was noticed in the sCD163 and TBil in patients of non-survival group compared to survival group. Before the artificial liver therapy, sCD163 was 1467.38±661.61ng/ml vs 935.30±532.98ng/ml (p< 0.001) and TBil was 462.81±107.50umol/L vs 324.16±91.78umol/L (p<0.01)in the non-survival group and survival group, respectively. After artificial liver therapy, sCD163 was 995.19±567.97ng/ml vs 664.67±597.70ng/ml (p<0.01)and TBil was 324.41±85.76umol/L vs 216.18±71.61umol/L(p<0.01) in the non-survival group and survival group,respectively. However, there were no significant statistical differences in the two groups of INR, PTA value before and after artificial liver therapy.ConclusionsCD163 has positive correlations with the mortality in patients of ACHBLF who received artificial liver therapy.