机构：[1]Department of Liver Diseases, The Third People's Hospital of Changzhou, Changzhou 213000, Jiangsu, China[2]Institute for the Study of Liver Diseases, The Third People's Hospital of Changzhou, Changzhou 213000, Jiangsu, China[3]Department of Infectious Diseases, The First Affiliated Hospital of Kunming Medical University, Kunming 650051, Yunnan, China昆明医科大学附属第一医院[4]Department of Pharmacy, The Third People's Hospital of Changzhou, Changzhou 213000, Jiangsu, China
Background: The gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a new noninvasive marker for assessing liver fibrosis. We aimed to evaluate the performance of GPR for prediction of 90-day mortality in patients with acute-on-chronic liver failure (ACLF). Methods: A total of 355 patients with HBV-associated ACLF were enrolled from two clinical centers and divided into training group (n = 210) and validation group (n = 145). Potential risk factors for 90-day mortality were analyzed. Results: Age, MELD score and GPR were independent risk factors associated with ACLF prognosis. A new scoring system (MELD-GPR) was developed. MELD-GPR = 9.211 - 0.029 x age - 0.290 x MELD - 0.460 x GPR. For ACLF patients with liver cirrhosis, the area under the receiver operating characteristic curve (AUROC) of MELD-GPR was 0.788, which was significantly higher than that of MELD and MELD-Na (0.706 and 0.666, respectively). Patients were stratified into three groups according to MELD-GPR scores (high risk: < -0.19, intermediate risk: - 0.19-0.95, and low risk: > 0.95), and the high-risk group (MELD-GPR < -0.19) had a poor prognosis (P < 0.01). For ACLF patients without liver cirrhosis, MELD-GPR < 0.95 predicted a poor prognosis. Conclusions: Incorporating GPR into MELD may provide more accurate survival prediction in patients with HBV-ACLF.
基金：
Chinese Foundation for Hepatitis Prevention and Control-Tianqing Liver Disease Research Fund Subject [TQGB201700139, TQGB20150006]; Major Projects of Changzhou Municipal Healthy and Family Planning Commission [ZD2011002]
第一作者机构：[1]Department of Liver Diseases, The Third People's Hospital of Changzhou, Changzhou 213000, Jiangsu, China[2]Institute for the Study of Liver Diseases, The Third People's Hospital of Changzhou, Changzhou 213000, Jiangsu, China
通讯作者：
通讯机构：[1]Department of Liver Diseases, The Third People's Hospital of Changzhou, Changzhou 213000, Jiangsu, China[2]Institute for the Study of Liver Diseases, The Third People's Hospital of Changzhou, Changzhou 213000, Jiangsu, China[*1]Department of Liver Diseases, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou 213000, Jiangsu, China
推荐引用方式(GB/T 7714)：
Liu Longgen,Lan Qing,Lin Lin,et al.Gamma-glutamyl transpeptidase-to-platelet ratio predicts the prognosis in HBV-associated acute-on-chronic liver failure[J].CLINICA CHIMICA ACTA.2018,476:92-97.doi:10.1016/j.cca.2017.11.017.
APA：
Liu, Longgen,Lan, Qing,Lin, Lin,Lu, Jianchun,Ye, Chunyan...&Xue, Yuan.(2018).Gamma-glutamyl transpeptidase-to-platelet ratio predicts the prognosis in HBV-associated acute-on-chronic liver failure.CLINICA CHIMICA ACTA,476,
MLA：
Liu, Longgen,et al."Gamma-glutamyl transpeptidase-to-platelet ratio predicts the prognosis in HBV-associated acute-on-chronic liver failure".CLINICA CHIMICA ACTA 476.(2018):92-97
