Correlation Analysis Between Platelet Count And Prognosis Of HBV-related Actue-On-Chronic Liver Failure

Objective: The relationship between platelet count and prognosis of patients with HBV-related actue-on-chronic liver failure was analyzed to provide basis for comprehensive prevention of those patients.Methods: This subject is a retrospective study.According to the inclusion and exclusion criterion,287 study members at Ningxia Medical University Hospital form 01/01/2013 to12/31/2016 were enrolled onto the study,the data of these patients,including age,gender,PLT,ALT,AST,TBil,PTA,INR,Na,Cr,Ca,HBV-DNA were collected.Of these,108 patients are HBV-related actue-on-chronic liver failure,70 patients are hepatitis B cirrhosis,79 patients are chronic hepatitis B,and 30 controls.Quantitative PLT,ALT,AST,TBil,PTA,INR,Cr,Ca,HBV-DNA of the four groups were comparatively analyzed to obverse the differences of PLT and other indicators in patients with hepatopathy at different periods.HBV-ACLF patients were based on clinical symptoms,TBil and PTA indicators as the criteria for judging the outcome,60 cases were divided into clinical treatment improvement group and 48 cases of worsening group.The differences of PLT on admission and PLT of 28 days after hospitalization and other index between the two groups were analyzed.Then the single factor and significant index in HBV-ACLF patients were introduced into Logistic multivariable regression analysis to determine whether PLT is an independent risk factor affecting prognosis.Finally,we compared the scores of PLT and MELD scores with ROC curve,and evaluated the value of PLT in evaluating prognosis.Results: 1.Platelet count in HBV-ACLF group was significantly reduced(P<0.05)compared with hepatitis B cirrhosis group,chronic hepatitis B group and control group.ALB,PTA,FIB,Ca were significantly reduced(P<0.05)and AST,TBil,INR were markedly elevated(P<0.05)in HBV-ACLF group compared with hepatitis B cirrhosis group,chronic hepatitis B group and control group.2.In HBV-ACLF patients,platelet count in clinical treatment worsening group was lower(P<0.05)compared with improvement group whenhospitalizing.Also platelet count at 28 days after hospitalization was analyzed,clinical treatment worsening group was significantly reduced(P<0.05)compared with improvement group.Quantitative TBil,Cr,INR,HBV-DNA and MELD scores were markedly elevated(P<0.05)in clinical treatment worsening group compared with improvement group.Platelet count in clinical treatment worsening group was significantly reduced(P<0.05)compared with improvement group.3.PLT,quantitative HBV-DNA,and MELD scores are independent risk factors affecting the prognosis of HBV-ACLF patients.4.The results of the ROC curve show that the MELD score and the PLT count at admission can predict the prognosis of the patients with a certain accuracy,but the accuracy of the MELD score is greater than that of the PLT count.Conclusions: 1.PLT,quantitative HBV-DNA,and MELD scores are independent risk factors affecting the prognosis of HBV-ACLF patients.2.PLT has certain reference value in evaluating the prognosis of HBV-ACLF patients.