Effects of ascites grading and the application of non-selective beta-blockers on the 1-year prognosis of acute-on-chronic liver failure
10.3760/cma.j.cn501113-20240130-00067
- VernacularTitle:腹水分级及非选择性β受体阻滞剂的应用对慢加急性肝衰竭1年预后的影响
- Author:
Wanshu LIU
1
;
Lijun SHEN
1
;
Xi HE
1
;
Hua TIAN
1
;
Qinghui ZHAI
1
;
Dongze LI
1
;
Shaojie XIN
1
;
Shaoli YOU
1
Author Information
1. 中国人民解放军总医院第五医学中心肝病医学部，北京 100039
- Publication Type:Journal Article
- Keywords:
Liver failure;
Ascites;
Nonselective beta blocker;
Therapeutic;
Prognosis
- From:
Chinese Journal of Hepatology
2025;33(1):57-62
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of ascites grading and the application of non-selective beta-blockers (NSBBs) on the 1-year prognosis of acute-on-chronic liver failure (ACLF).Methods:1 386 ascitic cases with ACLF were graded and followed up for one year. The 1-year prognostic effect of ascites grade and NSBBs was analyzed on ACLF by the Kaplan Meier Log-rank test, Cox stepwise regression, and multivariate regression.The t-test, Mann-Whitney U, or Kruskal-Wallis test were used for intergroup comparison of measurement data. The χ2 test was used for intergroup comparison of numerical data. Results:The incidence rate of ascites at admission was 77.56% in 1 386 ACLF cases. The Log-rank (Mantel-Cox) of the 1-year survival curve test for 1 386 ACLF patients with ascites grade was 21.384, P<0.01. Multivariate regression and Cox stepwise regression analysis showed that ascites grade, age, gastrointestinal bleeding, pulmonary infection, acute kidney injury, prothrombin activity (PTA), urea, MELD-Na score, and the use of NSBBs were closely related to the 1-year prognosis of ACLF. The log rank (Mantel-Cox) of NSBBs treatment in the grade 2/3 ascites group was 6.113, P=0.013, and the difference was statistically significant, suggesting that NSBBs treatment can help improve the 1-year survival rate in ACLF patients with grade 2 and 3 ascites. Conclusions:Ascites grading and the use of NSBBs affect the prognostic factor of ACLF at one year. NSBBs may be beneficial for the long-term prognosis of ACLF, and treatment can be continued in patients who have already received NSBBs prior to the onset of ACLF.
