胃肠病学

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). 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.