The relations between the liver function indexes and prognosis of severe hepatitis B: a meta-analysis study.

Objective To evaluate the prognostic significance of liver function indexes in severe hepatitis B.Method The results of 57 retrospective cohort studies from 1989 to 2007 were analyzed by Meta-analysis method.The overall case fatality of severe hepatitis B was 57.5% among the cumulative 31956 cases.Weighted mean differences(WMD)was applied to evaluate the risk of TBil,PTA,ALB,CHO,CHE,AFP,ALT and AST / ALT among severe hepatitis B patients.Receiver operating characterstic(ROC) applied to evaluate the sensitive of liver function indexes.Result The results showed that levels of ALT and AST / ALT showed no significant difference between death group and survivor group(P=0.54,0.09),but the levels of TBil in death group were much higher than survivor group(P0.01),and the levels of PTA,ALB,CHO,CHE and AFP were more obviously lower than survivor group(P0.01).ROC area under curve of AFP was highest(0.943,P0.01).Conclusion These finding suggest that TBil is a poor prognosis biomarker for patients,but may be a beneficial prognosis biomarker for patients,ALT and AST / ALT may not contribution for patient's survival.AFP,PTA and CHO are more sensitive than TBil,CHE and ALB in prognosis.