Clinical Significance Of PCT And AFP Detection In Patients With The Hepatitis B Virus-related Acute-on-chronic Liver Failure

Objective To observe the changes of PCT and AFP in patients with HBV-ACLF,and to evaluate the value of PCT and AFP in the prognosis of patients with HBV-ACLF.Methods 136 cases of HBV-ACLF patients were collected from Ningxia Medical University Hospital from January 2015 to December 2017 as the study subjects,and 50 patients with severe chronic hepatitis B(CHB)in the same period as the control group.According to the condition of patients discharged from hospital,HBV-ACLF was divided into improvement group(83 cases)and deterioration group(53 cases).For the collected clinical data of age,gender,PCT,AFP,etc.,the database was established by Microsoft Excel 2010,and further statistical analysis was performed by SPSS19.0 software.For qualitative data,the number of use cases(n),rate(%)was expressed,and the two groups were analyzed by chi-square test.For quantitative data,the mean ± standard deviation(?x?s)was used and the two groups were analyzed by independent sample t test.The meaningful single-factor indicators were screened out as PCT,AFP,MELD score,etc.Then,multivariate logistic regression analysis was used to conduct in-depth study to determine whether PCT and AFP were independent risk factors for the prognosis of patients with HBV-ACLF.Finally,the area under ROC(AUC)was used for independent risk factors to further evaluate its predictive value and predictive accuracy for patients with HBV-ACLF.Results 1.Analysis of clinical data of patients with HBV-ACLF and severe CHB,the results showed that 13 indicators of age,WBC,N%,TBil,ALP,GLU,urea,creatinine,INR,AFP,CRP,blood ammonia,spleen thickness of patients with HBV-ACLF were higher than those with severe CHB(P<0.05);the HGB,PLT,ALB,GGT,Na,PTA 6 indexes of HBV-ACLF patients were lower than those with severe CHB(P<0.05);There were no significant differences in the five indexes of ALT,AST,serum potassium and portal vein width(P>0.05).2.PCT < 0.5(ng/ml,the same below)was negative,PCT?0.5 was positive(0.5?PCT<2,2?PCT<10),The PCT analysis of the improved group(n = 83)and the deteriorated group(n = 53)in patients with HBV-ACLF showed that the improvement rate was 52.2% when PCT<0.5;the improvement rate was 7.35% when 0.5?PCT<2;and 1.47% when 2?PCT<10.The difference between the three was statistically significant(P<0.05).There were significant differences among the three groups(P < 0.05).The TBil,urea,creatinine,INR,MELD,Na,PTA and AFP in the improved group(n=83)and the deteriorated group(n=53)of patients with HBV-ACLF were analyzed with statistical significance(P<0.05).3.Multivariate logistic regression analysis showed that PCT and MELD scores were independent risk factors for the prognosis of patients with HBV-ACLF,and AFP was not an independent risk factor.4.The ROC of the subjects indicated that the area under the curve of PCT was 0.616 and the area under the curve of MELD score was 0.719,which indicated that PCT could predict the prognosis of ACLF,but its accuracy was lower than that of MELD score.Conclusion 1.PCT and MELD scores were independent risk factors for the prognosis of patients with the hepatitis B virus-related acute-on-chronic liver failure.2.PCT has certain reference value in the prognosis evaluation of patients with the hepatitis B virus-related acute-on-chronic liver failure.