Abstract: Objective To investigate the factors impacting the prognosis of patients with hepatitis B-induced acute-on-chronic liver failure（ACLF）.Methods 120 patients with hepatitis B-induced ACLF were admitted to our hospital between May 2014 and May 2017,and the clinical materials of all patients were retrospectively analyzed. All patients received conventional comprehensive medical treatments. The factors affecting prognosis was found by binary multivariate Logistic analysis.Results At the end of three to six month treatment,52 patients with ACLF（43.3%） survived and 68（56.7%） dies;at presentation, the gender,disease period,anti-viral therapy and artificial liver supporting approaches between the survivals and dead were not significantly different（P>0.05）,while the percentage of older than 50 yr and the incidence of complications in the survivals were significantly lower than those in the dead （40.4% and 46.1% vs. 61.8% and 79.4%,P<0.05）;serum PAB,TBA,BUN,Cr and HBV DNA levels in the two groups were not significantly different（P>0.05）,while serum bilirubin and prothrombin time in the survivals were significantly lower than in the dead（P<0.05）,and serum albumin,cholinesterase,total cholesterol and alpha-protein levels in the survivals were significantly higher than those in the dead（P<0.05）;the incidences of hepatic encephalopathy,hepatorenal syndrome,blood electrolyte imbalance and various complications in the survival group were 7.7%,1.9%,15.4% and 11.5%,much lower than 45.6%,14.7%,39.7% and 26.5% in the dead,respectivley （P<0.05）,while the incidences of upper gastrointestinal hemorrhage and spontaneous bacterial peritonitis in the two groups were not significantly different （P>0.05）;the Logistic analysis showed that the patients’age,blood prothrombin time, hepatic encephalopathy,electrolyte imbalance and complications were the independent factors influencing the prognosis of patients with hepatitis B-induced ACLF. Conclusion The clinicians should take the influencing factors of prognosis into consideration for early diagnosis and appropriate management of patients with ACLF in clinical practice to improve the survivals,which might include decreasing the occurrence of related complications and promoting liver regeneration in time.

Key words: Acute-on-chronic liver failure, Hepatitis B, Prognosis, Influencing factors