Dynamic interferon-inducible protein-10 expressions in the peripheral blood mononuclear cells and its prognostic value in patients with hepatitis B virus related acute-on-chronic live failure / 中华传染病杂志

ABSTRACT

Objective To investigate the predictive value of dynamic changes of interferon-inducible protein-10 (IP-10) expression in the peripheral blood mononuclear cells and the model for end-stage 1iver disease (MELD) scores for short-term mortality in hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) patients .Methods Eighty patients with HBV-ACLF admitted to the Affiliated Hospital of Hubei College of Arts and Sciences from October 2013 to August 2015 were selected .During 3 months of follow-up ,33 patients died and 47 survived .The expression level of IP-10 and MELD score of two groups were measured at admission and week 1 and week 2 after treatment .The means between two groups were compared .Accuracy of predicting short-term mortality was performed by area under receiver operating characteristic curve (AUC) .Multivariate logistic regression analysis and Kaplan-Meier survival curve were used to analyze the effect of IP-10 expression and MELD score on the mortality of HBV-ACLF patients . Results The expressions of IP-10 at admission and at week 1 and 2 after treatment in the death group were 1 .095 ± 0 .202 ,1 .071 ± 0 .181 ,and 1 .078 ± 0 .198 ,respectively ,those in the survival group were 0 .894 ± 0 .181 ,0 .770 ± 0 .153 ,and 0 .732 ± 0 .137 ,respectively ,which were significantly different (t =4 .66 ,8 .02 and 9 .27 ,respectively ,all P < 0 .01) .The MELD scores at admission and at week 1 and 2 after treatment in the death group were 26 .70 ± 5 .50 ,27 .39 ± 6 .24 ,and 28 .64 ± 6 .44 ,respectively , those in the survival group were 23 .89 ± 4 .41 ,21 .57 ± 4 .68 ,and 18 .87 ± 3 .92 ,respectively ,which were significantly different (t= 2 .53 ,4 .77 and 8 .42 ,respectively ,all P< 0 .01) .Analysis of variance showed that the MELD score and IP-10 expression in the survival group at admission were significantly higher than those at week 1 and week 2 after treatment (F= 13 .464 and 15 .711 ,respectively ,both P< 0 .01) ,while there were no significant differences in the death group (F = 0 .129 and 0 .864 ,respectively ,both P >0 .05) .The AUC of IP-10 at week 2 after treatment was 0 .935 ,that of MELD score was 0 .903 (Z =0 .788 ,P= 0 .045) ,while there was no significant difference of AUC between week 1 and week 2 (0 .935 vs 0 .909 ,Z = 0 .640 ,P> 0 .05) .In addition ,the AUC of IP-10 level at week 1 and MELD score at week 2 after treatment showed no significant difference (0 .909 vs 0 .903 ,Z = 0 .133 , P > 0 .05) .Logistic multivariate regression analysis showed that IP-10 ≥ 0 .902 at week 1 ,MELD ≥ 22 .5 and IP-10 ≥ 0 .846 at week 2 were independent risk factors for death (OR= 11 .29 ,6 .60 ,and 15 .27 ,respectively ;95％ CI =1 .06 - 119 .74 ,1 .27 - 34 .26 ,and 1 .39 - 167 .62 ,respectively ;all P< 0 .05) .Conclusion The dynamic monitor of both IP-10 levels and MELD scores may have greater value in predicting prognosis of patients with HBV-ACLF .