Abstract
OBJECTIVE: To investigate the effect of ALST (artificial liver support treatment) on inflammatory factors and prognosis in patients with ACLF (acute-on-chronic liver failure). METHODS: Data of ACLF patients admitted to the No. 2 People's Hospital of Lanzhou from June 2020 to January 2023 were retrospectively analyzed. Patients were compared before and after ALST in terms of ALT (Alanine Aminotransferase), AST (Aspartate Aminotransferase), TBil (Total Bilirubin), Cr (Creatinine), INR (International Normalized Ratio), MELD (Model for End-Stage Liver Disease) scores, as well as TNF-α (Tumor Necrosis Factor-α), IL-33 (Interleukin-33), and MIP-1α (Macrophage Inflammatory Protein-1 α) levels. The ROC (receiver operating characteristic) curve was used to analyze the efficacy of the above indicators in predicting 90-day mortality in patients. RESULTS: After the treatment, the levels of ALT, AST, TBil, Cr, INR, and MELD score were significantly lower than those before treatment (all P<0.001). Also, the levels of TNF-α, IL-33, and MIP-1α were substantially lower than those before treatment (all P<0.001). TNF-α, IL-33, and MIP-1α were positively correlated with MELD score before and after the treatment (all P<0.01). TNF-α, IL-33, MIP-1α, and MELD score were significantly higher in the death group than in the survival group (all P<0.01). The ROC curves showed that MELD (AUC=0.857), TNF-α (AUC=0.836), IL-33 (AUC=0.749), and MIP-1α (AUC=0.746) had high efficacy in predicting patients' 90-day mortality. CONCLUSION: ALST can significantly reduce TNF-α, IL-33, and MIP-1α levels in patients with ACLF, and postoperative TNF-α, IL-33, and MIP-1α levels have a high predictive value for patients' prognosis.