The Evaluating Value Of Serum Total Cholesterol,Serum Glucose And MELD For The Short-term Prognosis Of Hepatitis B-related Acute(Subacute)-on-chronic Liver Failure

Objective: To explore the predictive value of the serum total cholesterol,serum glucose and MELD model for the short-term(3 months)prognosis of Hepatitis B virus-associated slow-accelerated(sub-acute)liver failure(HBV-ACLF),so as to make a correct prediction of the early prognosis of hepatitis B-related acute(subacute)-on-chronic liver failure,a and to provide guidance for clinical treatment and rational distribution of liver sources.Methods: A total of 104 patients with HBV-ACLF of age,gender,liver biochemical indicators,and coagulation function indicators were collected,MELD were calculated respectively,and divided into an improved groups and an ineffective / deteriorated groups according to their recent outcome of the patients(3 months).At the same time,98 chronic HBV infectors were collected as control group.SPSS 20.0 statistical software package was used for processing.Comparisons of the counting data between two groups were performed by χ2 test or non-parametric test.Comparisons of the measurement data between two groups were performed using independent Student’s t test or non-parametric test.Univariate analysis was used to establish the correlative factors for the prognosis of HBV-ACLF patients,and then logistic regression analysis was performed to determine that total blood cholesterol,blood glucose and MELD were independent risk factors.Combining MELD score,total cholesterol and blood glucose to make a ROC curve,to understand its assessment of the recent prognosis of HBV-ACLF patients.Results: 1.The age and gender were no statistical difference between the liver failure group and the chronic HBV infectors group(P> 0.05);while the serum total cholesterol(TC),glutamic acid Aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBi L),γ-glutamyl transpeptidase(GGT),blood ammonia,cholinesterase,alkaline phosphatase,blood creatinine and blood sodium levels were statistically significant(P <0.05).2.The serum total cholesterol(TC),serum glucose(Glu)and the MELD score were statistically significant(P <0.05)between the improved groups and an ineffective / deteriorated groups,and related to the recent improvement rate of the patients.The other indicators were not statistically significant(P> 0.05)and had nothing to do with the recent improvement rate of the patients.3.Conditional Logistic model was used for multivariate analysis,which showed that TC,Glu,and MELD were independent risk factors for poor prognosis in patients with HBV-ACLF.4.Multivariate Logistic Regression Analysis of TC,Glu,and MELD upon Admission to HBV-ACLF Patients: we found that the higher MELD,the higher death rate.We also found that the lower TC and Glu levels on admission,the higher death rate.Conclusions: Based on the analysis of the association of indicators with short-term prognosis of HBV-ACLF patients,we predict the near-term prognosis of HBV-ACLF by combining total blood cholesterol,blood glucose and MELD scores.The combined prediction method of these three has a good value for the prediction of the short-term prognosis of HBV-ACLF,and had a certain guiding significance in clinical.