关键词: 慢加急性肝衰竭, 中性粒细胞/淋巴细胞比值, 白细胞介素6, 预后

Abstract: Objective The aim of this study was to investigate the predictive performance of short-term prognosis by neutrophil to lymphocyte ratio (NLR) and serum interleukin-6(IL-6) level in patients with acute-on-chronic hepatitis B liver failure (HBV-ACLF). Method 72 patients with HBV-ACLF were encountered in our hospital between September 2019 and September 2021, and were treated by comprehensive conventional supporting therapy. The blood routine was recorded, and serum IL-6 levels were assayed by ELISA. The impacting factors of short-term prognosis were analyzed by multivariate Logistic regression, and the predictive performance of NLR and serum IL-6 levels was evaluated by receiver operating characteristic (ROC) curve. Results The 28-day survival of the 72 patients in our series was 73.6%; the NLR was (7.2±2.2) and serum IL-6 level was (13.6±3.5)pg/ml in 19 dead patients with HBV-ACLF, significantly higher than [(3.7±1.0) and (8.7±1.5)pg/ml, respectively, P<0.05] in 53 survivals, the average age, incidence of hepatic encephalopathy (HE) and model of end stage liver disease (MELD) score in dead patients were significantly greater than, while the platelet count was significantly lower than in survivals (P<0.05); the Logistic regression analysis showed that the age, HE, MELD score, NLR and serum IL-6 levels were all the independent factors impacting the short-term prognosis (P＜0.05); the ROC analysis demonstrated that the combination of NLR (>4.93 as the cut-off-value) and serum IL-6 level (>10.9 pg/ml as the cut-off-value) in predicting the 28 day prognosis in patients with HBV-ACLF is promising, with the sensitivity of 100.0% and the specificity of 84.9%. Conclusion The application of NLR and serum IL-6 level combination in predicting the short-term prognosis of patients with HBV-ACLF is efficacious, which needs further clinical investigation.

Key words: Acute-on-chronic liver failure, Neutrophils to lymphocytes ratio, Interleukin-6, Prognosis