Complement C3 Facilitates Stratification of Stages of Chronic Hepatitis B and Signifies Development of Acute-on-Chronic Liver Failure in Acute Decompensated Cirrhosis.
Complement C3 Facilitates Stratification of Stages of Chronic Hepatitis B and Signifies Development of Acute-on-Chronic Liver Failure in Acute Decompensated Cirrhosis.
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DOI：
10.1007/s12325-022-02416-7
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发表时间：
2023-03
影响因子：
3.8
通讯作者：
Chen, Liang
中科院分区：
文献类型：
--
作者：
Chen, Chong;Yuan, Zhu;Li, Weixia;Fei, Ling;Ji, Liujuan;Huang, Qin;Zhang, Shuye;Chen, Liang
慢性B型肝炎（CH B）患者具有动态的疾病过程和终末期肝病的风险。关键是要明确区分疾病的阶段，并在不可逆的临床终点发生之前专注于治疗。我们回顾性分析了不同阶段的各种CHB患者。建立并验证了血清补体成分3（C3）水平对失代偿期肝硬化患者慢性加急性肝衰竭（ACLF）发展的预测能力。血清C3水平的降低与B型肝炎病毒相关疾病的严重程度有关。失代偿期肝硬化患者发生ACLF时血清C3水平显著低于其他患者（0.50 vs.0.80g/L，P < 0.001）。低血清C3水平是ACLF发生的危险因素（hazard ratio = 0.32，P < 0.01）。血清C3水平预测失代偿期肝硬化患者发生ACLF的受试者工作特征曲线下面积（auROC）为0.90，其敏感性和特异性分别为88.2%和88.7%。在验证集中观察到类似的结果（auROC = 0.86，用于预测失代偿期肝硬化患者发生ACLF）。血清C3水平在评估CHB相关阶段的严重程度中是有价值的。低C3水平提示失代偿期肝硬化患者发生ACLF。在线版本包含补充材料，可通过10.1007/s12325-022-02416-7获得。一般来说，慢性加急性肝衰竭是一种快速恶化的肝衰竭综合征。该病难治性强，死亡率高。肝脏的急性失代偿被定义为肝病并发症的发生（即，腹水、肝性脑病、胃肠道出血和细菌感染）。临床上，B型肝炎病毒相关肝硬化的急性失代偿（病毒引起的慢性肝损伤的结果）常常发展为慢性加急性肝衰竭。此外，补体成分3是一种血清蛋白，其参与针对病毒感染的免疫应答，并已报道与肝衰竭相关。本研究旨在探讨血清补体成分3（C3）的变化特点，以区分肝硬化的不同阶段，并评估其对慢加急性肝衰竭的预测价值。因此，我们分析了广泛的B型肝炎肝硬化患者的补体成分3数据。通过分析，我们发现补体成分3水平在评估慢性乙型肝炎相关阶段的严重程度方面具有价值。低补体成分3水平也可能意味着失代偿性肝硬化患者慢性加急性肝衰竭的发展。在线版本包含补充材料，可通过10.1007/s12325-022-02416-7获得。
Patients with chronic hepatitis B (CHB) have a dynamic disease process and risk of end-stage liver disease. It is critical to unambiguously differentiate the stages of the disease and focus on therapy prior to onset of an irreversible clinical endpoint. We retrospectively analyzed a wide range of CHB patients at different stages. The predictive power of serum complement component 3 (C3) levels for the development of acute-on-chronic liver failure (ACLF) in patients with decompensated cirrhosis was established and validated. The decrease in serum C3 levels paralleled the severity of diseases related to hepatitis B virus. Patients with decompensated cirrhosis who developed ACLF had significantly lower serum C3 levels than others on admission (0.50 vs. 0.80 g/L, P < 0.001). Data analysis also revealed that low serum C3 was a significant risk factor for developing ACLF (hazard ratio = 0.32, P < 0.01). The area under the receiver operating characteristic curve (auROC) for serum C3 levels that predicted the development of ACLF in patients with decompensated cirrhosis was 0.90, which had sensitivity and specificity of 88.2% and 88.7%, respectively. A similar result was observed in the validation set (auROC = 0.86 for predicting development of ACLF in patients with decompensated cirrhosis). Serum C3 levels are valuable in assessing the severity of CHB-related stages. Low C3 levels signifies the development of ACLF in patients with decompensated cirrhosis. The online version contains supplementary material available at 10.1007/s12325-022-02416-7. Generally, acute-on-chronic liver failure is a rapidly worsening liver failure syndrome. This disease is intractable and with high mortality. Acute decompensation of the liver is defined as the occurrence of complications of liver disease (i.e., ascites, hepatic encephalopathy, gastrointestinal bleeding, and bacterial infection). Clinically, acute decompensation in hepatitis B virus-related cirrhosis (a result of chronic liver injury by virus) often develops into acute-on-chronic liver failure. In addition, the complement component 3 is a serum protein, which participates in the immune response against virus infection and has been reported to be associated with liver failure. We tried to explore the feature of serum complement component 3 to differentiate the stages of the disease and assess its predictive value for acute-on-chronic liver failure. So, we analyzed the complement component 3 data from a broad range of hepatitis B virus-cirrhosis patients. Through analysis, we found that complement component 3 levels are valuable in assessing the severity of chronic hepatitis B-related stages. Low complement component 3 levels can also signify the development of acute-on-chronic liver failure in patients with decompensated cirrhosis. The online version contains supplementary material available at 10.1007/s12325-022-02416-7.
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影响因子：
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作者：
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DOI：
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