Clinical Study on CLIF-C OFs for Distinguishing Acute-on-chronic Liver Failure in Non-HBV-related Chronic Liver Disease with Acute Decompensation
10.3969/j.issn.1008-7125.2015.10.002
- VernacularTitle:CLIF-C OFs 在非乙型肝炎相关慢性肝病急性失代偿患者中鉴别慢加急性肝功能衰竭的临床研究
- Author:
Ru DING
;
Bo ZENG
;
Liuying CHEN
;
Shuting LI
;
Nannan ZHANG
;
Hai LI
- Publication Type:Journal Article
- Keywords:
Liver Diseases;
Acute Decompensation;
Multiple Organ Failure;
Acute-On-Chronic Liver Failure
- From:
Chinese Journal of Gastroenterology
2015;(10):581-586
- CountryChina
- Language:Chinese
-
Abstract:
Background:A recent perspective European study has shown that Chronic Liver Failure-Consortium Organ Failure score(CLIF-C OFs)is an effective diagnostic criteria for acute-on-chronic liver failure(ACLF)in alcoholic or hepatitis C virus patients with acute decompensation(AD). Aims:To assess the efficacy of CLIF-C OFs for distinguishing ACLF in non-hepatitis B virus(HBV)-related chronic liver disease patients with AD. Methods:A total of 274 consecutive non-HBV-related chronic liver disease patients with AD from Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled. Patients were divided into three groups:ACLF at admission,ACLF developed within 28-day and non-ACLF according to CLIF-C OFs criteria. Clinical and biochemistry characteristics,severity of the disease and 28-day and 90-day mortality data between ACLF and non-ACLF groups were analyzed. Results:Of the patients assessed,40 had ACLF at admission,27 had ACLF developed within 28-day,207 remained not having ACLF. Patients in ACLF group had higher TB,Cr,INR,ALT,AST,ALB,WBC,score of Child-Pugh,CTP,MELD,MELD-Na than non-ACLF patients(P <0. 05),and were younger in age(P < 0. 01). Incidences of hepatic,renal,cerebral,coagulation,circulation and lung failure,28-day mortality,90-day mortality were significantly higher in ACLF group than in non-ACLF patients( P <0. 01). However,no significant differences were seen in the characteristics mentioned above between ACLF at admission group and ACLF developed at 28-day group(P > 0. 05). TB level at admission and infection occurred within 28-day were the risk factors for developing ACLF(P < 0. 05). Conclusions:ACLF constitutes a more severe subgroup in non-HBV-related chronic liver disease patients with AD,and CLIF-C OFs could help to distinguish ACLF patients out from non-HBV-related chronic liver disease patients with AD.