中文摘要：

目的 探讨肝衰竭分期对乙型慢加急性肝衰竭（HBV-acute-on-chronic liver failure,HBV-ACLF）预后判断的临床意义.方法 将我院2009年6月-2011年4月收治的422例HBV-ACLF患者作为研究对象,根据入组时病情及住院期间最差状态将患者分为早、中、晚期,分析其24周生存状况.结果 按入组时凝血酶原活动度（prothrombin activity,PA）、并发症情况判断的早、中、晚期患者分别有183例、133例、106例,4周时死亡率分别为18.58％、24.81％、79.25％,24周时死亡率分别为33.33％、45.11％、84.91％.按患者住院期间最差状态分期,199例患者属于晚期,24周死亡率为88.44％.根据入组后1个月内最高晚期肝病模型（model for end-stage liver disease,Meld）分值将422例患者分为5组,组间24周死亡率差异有统计学意义,但死亡率并未与Meld评分完全呈正比.结论 肝衰竭分期可更好地预测HBV-ACLF患者的24周死亡风险.

英文摘要：

Objective To study the clinical significance of liver failure staging in predicting the prognosis of HBV-acute-on-chronic liver failure （HBV-ACLF）.Methods Four hundred and twenty-two HBV-ACLF patients admitted to our hospital from June 2009 to April 2011 were divided into early stage group （n=183）,middle stage group （n=133） and end stage group （n=106）.Their survival rates were analyzed.Results The mortality of the 3 groups at 4th week and 24th week was 18.58%,24.81%,79.25% and 33.33%,45.11%,84.91%,respectively,according to their prothrombin activity （PA） and complications at admission.The mortality of 199 end stage patients at 24th week was 88.44% according to the severity of HBV-ACLF in hospital stay time.The mortality at week 24 was significantly different in 5 groups divided according to the end-stage liver disease model.However,the mortality was not proportional to the end-stage liver disease model.Conclusion Liver failure staging can accurately predict the mortality in HBV-ACLF patients.