Value of indicators including serum neuron-specific enolase in assessing prognosis of patients with cirrhosis complicated by overt hepatic encephalopathy
- VernacularTitle:血清神经元特异性烯醇化酶等指标预测肝硬化合并显性肝性脑病患者预后的价值
- Author:
Ke REN
1
;
Lijun TIAN
;
Xiaoying HUANG
;
Xudong HAN
;
Ying ZHANG
Author Information
- Publication Type:Research Article
- Keywords: serum neuron specificity enolase; prognostic nutritional index score; integrated end-stage liver disease model; liver cirrhosis; overt hepatic encephalopathy
- From: Journal of Clinical Medicine in Practice 2024;28(17):35-40
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of serum neuron-specific enolase (NSE), prognostic nutritional index (PNI) score, hepatic encephalopathy (HE) grading, and the integrated model for end-stage liver disease (iMELD) score in assessing the short-term (90-day) prognosis of patients with cirrhosis complicated by overt hepatic encephalopathy (HE). Methods A retrospective analysis was conducted on clinical data from 470 patients with cirrhosis and overt HE, and they were divided into survival group (
n =359) and mortality group (n =111) based on their survival status 90 days after admission. The PNI and iMELD scores were calculated using patient demographics, blood routine tests, coagulation function, liver and renal function electrolyte levels, and serum NSE levels within 24 hours of admission, along with HE grading. Receiver operating characteristic (ROC) curves, multivariate Logistic regression analysis, and Kaplan-Meier survival curves were employed to evaluate influencing factors of short-term prognosis of patients with cirrhosis and overt HE. Results The mortality group exhibited significantly higher serum NSE levels, HE grades, and iMELD scores, while demonstrated lower PNI score compared to the survival group (P < 0.05). Multivariate Logistic regression analysis identified serum NSE, PNI score, HE grade, and iMELD score as independent predictors of short-term prognosis. The areas under the curve (AUCs) for serum NSE, PNI score, HE grade, and iMELD score in predicting short-term prognosis were 0.727, 0.717, 0.721, and 0.728, respectively, with cut-off values of 12.23 ng/mL, 34.05 ng/mL, and 39.26 points for serum NSE, PNI score, and iMELD score. A combined prediction model of four factors demonstrated the highest predictive performance, with an AUC of 0.919 and a cut-off value of 0.23. Kaplan-Meier survival analysis revealed that patients with combined score of serum NSE, PNI score, HE grade, and iMELD cut-off value < 0.23 had a significantly higher 90-day survival rate compared to those with cut-off value≥0.23 (Log-Rank=265.567,P < 0.001). Conclusion Serum NSE, PNI score, HE grade, and iMELD score exhibit good value in predicting the short-term prognosis of patients with cirrhosis and overt HE, with an even higher predictive value when used in combination.
