Liu Ming,Deng Guohong,Tan Shun,Liu Hongli,Sun Xiaowen,Tan Wenting,Mao Qing.Routine early clinical warning indicators of acute-on-chronic pre-liver failure[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(08):772-775.
Liu Ming,Deng Guohong,Tan Shun,Liu Hongli,Sun Xiaowen,Tan Wenting,Mao Qing.Routine early clinical warning indicators of acute-on-chronic pre-liver failure[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(08):772-775.DOI:
Routine early clinical warning indicators of acute-on-chronic pre-liver failure
Objective To establish the clinical indicators-based early liver failure warning model by analyzing the clinical characteristics and digging the early warning indicators of prophase acute-on-chronic liver failure (Pre-ACLF). Methods Fifty patients with acute-on-chronic pre-liver failure (group A) and 62 patients with severe chronic hepatitis B (group B) were retrospectively analyzed. Their predisposing factors
disease onset characteristics
and routine clinical indicators were compared. A liver failure risk model was established by logistic regression analysis. Results No significant difference was found in gender
predisposing factors
jaundice-occuring time
liver cirrhosis
and HBeAg positive rate between the two groups. The disease onset age was 12 to 72 years in group B and 29 to 69 years in group A (P0.05). Blood coagulation function test and serum TBil level were significantly different between the two groups. The PT
INR and TBil levels were significantly higher in group A than in group B (P0.05). The incidence of ACLF in the early warning model was P=1/[1+e^-(-2.414+7.687 PT rising rate)]. The maximum rising rate of PT was one second per day and the liver failure risk increased 2 179.045 times. Conclusion The lesion is relatively severer in patients with prophase Pre-ACLF than in those with severe chronic hepatitis B
which is mainly characterized by dramatic blood coagulation function fall and significant jaundice increase. The maximum rising rate of PT is the strongest risk factor for liver failure.