全身免疫炎症指数联合外周血血清甲胎蛋白、谷氨酰转移酶检测对乙型肝炎病毒相关慢加急性肝衰竭患者预后的评估价值

Objective To analyze the evaluative value of systemic immune-inflammation index(SII) combined with peripheral blood serum alpha fetoprotein (AFP) and gamma-glutamyl transpeptidase(GGT) detection in the prognosis assessment of patients with hepatitis B virus - related acute - on - chronic liver failure (HBV-ACLF). Methods The clinical data of 112 HBV - ACLF patients diagnosed and treated in our hospital from January 2023 to December 2024 were retrospectively included in the study. They were divided into a death group (45 cases) and a survival group (67 cases) according to the prognosis. The predictive value of related indexes for the poor prognosis was analyzed. Results The positive rate of hepatitis B e antigen (HbeAg), incidence of diabetes, infection, blood alanine aminotransferase (ALT), aspartate aminotransferase (AST), AFP, GGT, international normalized ratio, SII, and Asia-Pacific Association for the Study of Acute-on-Chronic Liver Failure (AARC) score in the death group were higher than those in the survival group (P＜0.05). The albumin, serum sodium, platelet count and lymphocyte count in the death group were significantly lower than those in the survival group (P＜0.05). Pearson correlation analysis showed that SII, AFP and GGT were positively correlated with the AARC score (rSII=0.678, rAFP=0.721, rGGT=0.654, all P＜0.001). The areas under the curves of SII, AFP and GGT for predicting short - term death in HBV - ACLF patients were 0.786, 0.754 and 0.732 respectively, and the area under the curve(AUC) of combining parameters for short - term death prediction was 0.856. Conclusion Systemic immune inflammation index, peripheral blood AFP and GGT have good predictive value for the prognosis of patients with HBV-ACLF.